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Biomedical subjects

J Jurkiewicz

Publications and source records attributed to J Jurkiewicz.

At least 55 records · Page 3Linked to original sources
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[The complementation test with feedback. Preliminary assessment of the test and comparison with a test using a continuous infusion rate].

The complementation test with feedback is described as a method for the assessment of disturbances of volume-pressure compensation. The method is characterized by changing infusion rate and the value of this rate depends on the value of cerebrospinal fluid pressure rise in the test. The infusion is stopped when the relative pressure rise reaches 10 mm Hg. Computer-assisted control of infusion and pressure measurement makes possible achieving of greater accuracy of determination of parameters. The test with feedback was compared with the test with stable infusion rate with regard to the indices characterizing the invasiveness of the method. A statistically significant reduction of this invasiveness was noted.

Cerebrospinal Fluid Pressure↗
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[Cryohypophysectomy in acromegaly and gigantism by the stereotaxic method].

The authors report results of surgical treatment of 30 patients treated by cryohypophysectomy by the stereotactic method through the nose and sphenoid sinus in the years 1967-1979. The material included 28 cases of acromegaly and 2 cases of gigantism. The pathological manifestations in acromegaly and gigantism were analysed for demonstration which of them can regress after surgical treatment. The results of hormonal determinations, particularly the levels of growth hormone, 17-KS and hydroxysteroids, as well as blood glucose curves, were compared before and after cryohypophysectomy and their normalization was observed after the operation. There was principally no need for substitutive treatment after surgical treatment with the exception of 4 cases in which this treatment was given during several postoperative months. The indications to this method of therapy include cases of acromegaly and gigantism with presence of active intrasellar adenomas. Patients should be referred for treatment early before development of skeletal deformities.

Acromegaly↗
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[Concentration of lactates, sodium and potassium in brain tissue obtained during neurosurgery].

In samples of brain tissue obtained during operations from 40 neurosurgical patients the concentrations of lactate, sodium and potassium were determined. A statistically significant fall of potassium concentration and increased sodium concentration was found in patients with lactate concentration exceeding 0.9 mg/g of fresh tissue. All patients with raised lactate level in the cerebrospinal fluid before the operation tolerated poorly the neurosurgical intervention. Examination of brain tissue in these cases showed changes compatible with advanced brain oedema.

Adolescent↗
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[Computerized infusion test. II. Clinical use].

In 39 patients with intracranial lesions the resorption resistance was measured using an own computerized infusion test. A high usefulness of this test was demonstrated in the diagnosis of hydrocephalus and for establishing indications to ventriculocardiac valve implantation. In patients after craniocerebral injuries a rise was observed of the resorption resistance immediately after trauma in cases with subarachnoid haemorrhage. Later on, this resistance decreased gradually reaching a stable value after 1-2 years. Data obtained in the infusion test make possible establishing of optimal intracranial pressure and choice of an appropriate valve. The determination can be performed intraoperatively.

Brain Injuries↗
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[Diagnosis of brain stem ischemia by transcranial Doppler ultrasonography].

Intracranial pressure (ICP) was elevated in cats by intrathecal infusions. Middle cerebral artery and basilar artery were studied using Transcranial Doppler (TCD) during the infusion followed by systemic arterial pressure increase (Cushing response). Cushing response was symptomatic for brain stem ischaemia. The earliest TCD changes concerned the basilar artery. The most informative data for the diagnosis were pulsatility index increase and diastolic velocity decrease.

Animals↗
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[Application of transcranial Doppler ultrasonography in the assessment of cerebrovascular reactivity studies and cerebral vascular reserve estimation in patients with focal brain injury].

Cerebrovascular reactivity and cerebrovascular reserve were studied using transcranial Doppler sonography (TCD). Investigations were carried out in acute cases--8 patients with severe head injury within 5 days after trauma and in chronic cases with brain tissue defect (12 patients), and in cases with cerebral circulation insufficiency (15 patients). In acute cases the pCO2 cerebrovascular response was studied and in chronic cases cerebrovascular reserve was estimated using acetazolamide. TCD was found suitable for local vascular reactivity disturbances determination independently in three intracranial compartments--both hemispheres and infratentorial space. In patients with local brain tissue defect cerebrovascular reserve remained within normal range. In cerebral circulation insufficiency vascular reserve disturbances were limited to one compartment in cases with local vascular lesion they were found in all three compartments in cases with generalized atheromatosis.

Acetazolamide↗
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[Application of physiological loadings in evaluation of intracranial volume-pressure relations. II. Clinical studies].

The effects of physiological loadings (venous pressure increase, postural changes, pCO2 increase) on intracranial volume-pressure relations were studied. The standardized increase of venous outflow pressure was found to be a good test for the evaluation of CSF outflow routes. Standardized venous outflow pressure increase in Queckenstedt test seems to be especially useful.

Adult↗
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[Intracranial volume reserve assessment based on ICP pulse wave analysis].

ICP waves were analysed in the situation of expanding intracranial mass. The aim of the study was to determine how big the intracranial added volume has to be in order to produce significant changes of harmonic disturbances index (HFC) of ICP pulse waves. The diagnostic value of HFC and other parameters was compared. The following other parameters were studied: intracranial pressure (ICP), CSF outflow resistance (R), volume pressure response (VPR) and visual evoked potentials (VEP). It was found that ICP wave analysis very clearly reflects the intracranial volume-pressure relation changes.

Animals↗
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[Three-phase infusion test].

A new CSF circulation diagnostic procedure is presented. The method is called three-phase infusion test. In phase I the CSF absorption mechanisms were tested within ICP range below 20 mmHg and then the infusion rate of 0.06 ml/min was applied. In phase II the high infusion rate (0.3 ml/min) was used and high ICP increase occurred. This part of the study provided data concerning the ability of alternative CSF outflow routes. In phase III again low infusion rate (0.06 ml/min) was applied. The obtained CSF outflow data in phase III were significantly lower than in phase I. This is the so called persistent outflow facilitation phenomenon. The method described, covering different mechanisms of CSF absorption, enables the complex evaluation of CSF outflow sufficiency.

Animals↗
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[Hazards of uncontrolled administration of dehydrating agents].

A 38-year-old male patient was admitted to a neurosurgical hospital department because of hemiparesis and speech disturbances which had developed during an acute febrile disease. In view of supposed brain tumour the patient had been given prior to admission to the neurosurgical department high doses of dehydrating agents which resulted in high grade dehydration of the patient. During 10 days it was possible to achieve compensation of water and electrolyte disturbances and simultaneously hemiparesis regressed and function of speech improved. Angiography ruled out presence of brain tumour. The patient had no neurological disturbances during follow-up examination 6 months after discharge from the hospital. In the case the cerebral distrubances were due probably to venous thrombosis and intensive dehydrating therapy had contributed considerably to the severe condition of the patient.

Adult↗
PubMedDate not supplied

[Evaluation of perceptive activity in persons with low pressure hydrocephalus treated surgically. Preliminary report].

Preliminary assessment of perceptive activity was carried out in patients with low-pressure hydrocephalus diagnosed clinically. The purpose of the study was establishing of the valuable tests for the neuropsychological diagnosis making possible finding of perceptive processes most frequently disturbed in low-pressure hydrocephalus. The studied group comprised 53 patients operated on for this hydrocephalus. In only 9 cases the condition of the patient made possible a detailed study of the perceptive processes. In this group the tests were carried out three times: before, immediately and after a longer time after insertion of ventriculoperitoneal shunt. The results showed differences in the level of general perceptive functioning in the whole group. In the subgroup studied in detail no general perception deterioration was found, and the usual disturbances were noted in the memorization of new information and in visuospatial orientation. Late after the operation the greatest improvement was observed in the most disturbed functions.

Adult↗
PubMedDate not supplied

[Multi-stage method for the diagnosis of low-pressure hydrocephalus].

Multistage method of low-pressure hydrocephalus diagnosis, elaborated in our department, is discussed. The method consists of four stages: I Clinical and neuropsychological examinations, standard computerized tomography. II Somatosensory evoked potentials. III Determination of water concentration and distribution in fluid compartments of the brain by utilising new mathematical formula. IV Three-phase complementary test. The application of this method allows to eliminate many false diagnoses and may contribute to lower costs of treatment.

Body Fluid Compartments↗