Biomedical subjects
Publications and source records attributed to J Grodecki.
An anatomical study was made of the dorsal digital apparatus, a complex anatomical structure responsible for the extension of the fingers, and it was found to have an adequate blood supply. The relative abundance of blood vessels supplying the dorsal digital apparatus, their anastomoses and the details of their branching should be of interest to those involved in the surgical repair of this structure.
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The arterial supply to the flexor tendons of the fingers was studied by means of angiography, by the injection of coloured latex, and by microdissection. It was established that there were no anastomoses between the intra-osseous circulation and that of the synovial sheath. Two separate sources of blood supply to the sheath were found: the digitopalmar arches and the specific arteries of the sheath. The findings indicate that the ideal location for incision into the digital sheath is in the midline of the palmar surface. The flexor tendons within the sheath are supplied only by branches of the digitopalmar arches. Considerable differences were observed in the details of blood supply of the tendon of flexor superficialis and that of flexor profundus.
In ten human hands the mesotendons of m. extensor digitorum longus and m. extensor indicis have been examined and described in detail. The various sources of their blood supplies have also been demonstrated and described.
Concerning a displacement in distal direction of the insertions of the ligamentum collaterale fibulare and of the tendo musculi bicipitis femoris on the superior epiphysis of the fibula, the authors describe in detail and in millimetrical scale the permanent existence of bundles, additionnal to the main insertions known up to now, and of a sheath envelopping the ligament. The study of the organogenesis of these formations, followed by their dissection at an adult stage allow to estimate the genetical, mechanical, and constitutional factors explaining the usual variations of these structures.
An effect of isosorbide dinitrate on blood pressure values in the pulmonary circulation and the right heart has been investigated in 25 patients with a history of the first transmural myocardial infarction. Group I including 12 patients has been given 5 mg isosorbide nitrate in a 60-minute intravenous infusion while group II of 13 patients has been given 10 mg of the drug in the same way. Both groups have been matched in clinical data and blood pressure value in the pulmonary circulation which has been normal. Pulmonary blood pressure has been measured with Swan-Ganz catheter prior to the administration of drug, and 15, 30, 45 and 60 minutes following an infusion. Isosorbide dinitrate in a dose of 5 mg did not decrease blood pressure in the pulmonary circulation statistically significantly. The differences in blood pressure falls did exceed 9%. Filling pressure in the right ventricle did not change either while systolic blood pressure decrease by 16.6%. A double dose of isosorbide dinitrate reduced blood pressure in the pulmonary artery by about 1/3 of the baseline value, and blood pressure in the right ventricle (mean right atrial pressure) by 57.2%. Both systolic and diastolic arterial pressures were reduced. Isosorbide dinitrate reduced blood pressure in the pulmonary circulation in patients who underwent myocardial infarction, and hypotensive effect has been dose-related. A reduction in the right ventricular filling pressure has been a one of important mechanisms decreasing pulmonary pressures.
In a group of 37 patients (30 men and 7 women aged from 36 to 67 years, men age 50.3) after a first acute myocardial infarction the frequency was analysed of the episodes of silent myocardial ischaemia with ST depression, and its correlation with arrhythmia was studied during outpatient ECG monitoring and exercise test on cycle ergometer. Outpatient ECG monitoring during 24 hours was done with a recorder Oxford Medilog MR-14 AM System 8-12 weeks after the onset of infarction. In the same patients the exercise test on cycle ergometer (KF-12 Medicor) was done by graded exercise method with workload increasing by 25 Watt every 3 minutes. The test was terminated after achieving 85% maximal heart rate or appearance of limiting signs. Each episode of ST depression by 1.0 mm or more lasting over 1 minute with horizontal or sloping ST depression 80 msec from point J was regarded in both cases as ischaemic. During outpatient ECG monitoring it was observed that 30 out of 37 (81.1%) had 138 episodes of ST depression, including 45 (32.6%) associated with pain and 93 (67.9%) painless (p less than 0.02). The mean maximal ST depression during painful and painless episodes was respectively 3.4 +/- 1.3 mm and 2.9 +/- 1.1 mm (p less than 0.03). Out of 30 patients 7 (23.3%) had 54 episodes of various arrhythmias, with bursts of ventricular ectopic beats, in one patient supraventricular tachycardia and in another one grade II atrioventricular block developed. These patients had also isolated ventricular ectopic beats. In 6 patients (20.0%) arrhythmia was temporarily associated with signs of ischaemia with ST depression.(ABSTRACT TRUNCATED AT 250 WORDS)