Search PubMed⌕ Search

Biomedical subjects

J Kochanowski

Publications and source records attributed to J Kochanowski.

At least 19 recordsLinked to original sources

[Effect of postinfarct left ventricular dysfunction on late occurrence of mitral regurgitation--two year experience].

The aim of this study was to evaluate factors that might influence on the occurrence of mitral regurgitation (MR) in patients (pts) following myocardial infarction (MI) after fibrinolysis--two year experience. The study group comprised 118 pts: 40 women and 78 men (mean age: 58 +/- 9 years) following MI, who underwent Doppler echocardiography which revealed no MR 3 weeks after the MI. The second echocardiographic examination was performed after 2 years. We evaluated the following parameters: presence and stage of MR, left ventricular end-diastolic diameter (LVDD), left atrial diameter (LA), end-diastolic volume (EDV), wall motion score index (WMSI), asynergic area (AA) and ejection fraction (EF). Results after 2 years were as follows: 43 pts (36%) presented without MR, 45 (38%) MR I degree, 27 (23%) MR II degree, 3 (3%) MR III degree. Echocardiographic parameter comparison after 2 years demonstrated the following changes: LVDD increase from 5.0 +/- 0.5 cm to 5.3 +/- 4.6 cm (p < 0.005), LA increase from 3.7 +/- 0.4 cm to 4.3 +/- 0.4 cm (p < 0.00001), EDV increase from 130 +/- 29 ml to 147 +/- 39 ml (p < 0.005), WMSI increase from 1.37 +/- 0.23 to 1.45 +/- 0.21 (p < 0.05), AA increase from 23.5 +/- 10.1% to 27.8 +/- 7.9% (p < 0.005) and significant EF decrease 50.4 +/- 7.9% to 46.9 +/- 7.1% (p < 0.005). These results demonstrate that the occurrence of MR 2 years after the MI is caused by left ventricular remodelling, as well as segmental and global function deterioration.

Adult↗

Effect of treatment with 21-aminosteroid U-74389G and glucocorticoid steroid methylprednisolone on somatosensory evoked potentials in rat spinal cord during mild compression.

The purpose of this investigation was to compare the effects of treatment with glucocorticoid steroid methylprednisolone (MP) and the 21-aminosteroid U-74389G on the conduction of somatosensory evoked potentials (SEPs) during experimental spinal cord compression. Forty-five adult male Wistar rats were anesthetized and a laminectomy performed at the Th9-Th10 level. Animals with the same SEP patterns prior to and after laminectomy were randomly allocated to one of three groups (15 rats in each). A 14.8-g weight was applied to the dural surface of the spinal cord for 60 min. The SEPs were continually recorded during compression. The rats received a single intravenous bolus dose of three different agents two minutes after the start of compression. Animals in the first group received 0.5 ml of 0.9% NaCl, the second group received 30 mg/kg methylprednisolone and the third group received 3 mg/kg U-74389G. Following drug infusion the time period required for the SEPs to be completely suppressed was assessed. If the SEPs were not fully suppressed, the amplitude of the most stable and significant component of the SEPs was measured. The time taken to complete the SEPs suppression was significantly shorter in the control group (p < 0.001, Wilcoxon) than in the groups with either MP or U-74389G. However, the time taken to achieve full suppression was not significantly different between the MP and U-74389G groups. The proportional reduction of amplitude N1P1 was significantly different between the control and MP groups as well as between the control and U-74389G groups. The proportional reduction of amplitude N1P1 was not significant between the MP and the U-74389G groups. The present data indicate that both the glucocorticoid steroid MP and the 21-aminosteroid U-74389G protect spinal cord function to a similar extent during mild compression.

Afferent Pathways↗

[Prophylactic treatment of migraine].

Migraine belongs to the most frequent idiopathic headaches affecting 5-10% of the population. The knowledge of migraine pathogenesis is as yet insufficient for complete elucidation of its causes. There is no effective drug for all patients which could interrupt the attack or prevent its development. The methods of migraine prevention could be divided into pharmacological and non-pharmacological. Among the drugs used for attack prevention drugs are mentioned known and used since a long time and drugs less commonly used such as riboflavin, sulpiride, alpha-adrenolytic agents. Own experiences are presented with the use of iprasochrom for migraine prevention. Besides pharmacological methods also non-pharmacological methods are discussed which are applied for attack prevention.

Adrenergic alpha-Antagonists↗

[Pathophysiology and treatment of spinal cord medulla injuries].

In view of the ever increasing incidence of spinal cord injuries and their very high socioeconomic costs studies are conducted for reduction of their consequences. In recent years considerable advances have been achieved in their treatment. The contribution of various mechanisms damaging spinal cord is known presently rather well, with isolation of two groups of causes: one is the primary spinal cord injury as a result of direct force acting on it during trauma, the other is secondary damage caused by vascular changes following trauma, free radicals, calcium distribution changes, participation of opioid receptors and inflammatory process. For counteracting these mechanisms in secondary cord damage treatment with drugs is justified. Among the drugs the main role is played by steroids--both glucocorticoids and non-glucocorticoids /lazaroids or aminosteroids/. Other drugs include calcium channel blockers, opioid receptor antagonists, serotonin antagonists, cyclo-oxygenase inhibitors, osmotically active drugs, antioxidants, NMDA receptor antagonists. Besides drugs hypervolaemia, haemodilution and hypothermia are tried. Proper diagnostic procedures and effective treatment of cord injury consequences depend on the knowledge of the mechanisms of later consequences of cord injury, this enables achieving of ever more effective treatment results.

Antioxidants↗

[Clinical applications of late negative evoked potentials--contingent negative variation (CNV)].

Contingent negative variation /CNV/ is a slow negative potential described first in 1964 by Walter et al. It is a correlate of cerebral activity in the frontal lobes connected with expectation of stimulus and frontal cortex preparation for the stimulus to come. CNV develops in the time between the warning signal /S1/ and the commanding signal /S2/. CNV contains two main components connected directly with brain function: the first one, so called early component, is connected with the process of orientation or warning /it is called also orientation wave/, the second one /late component/ is connected with the preparation for movement /expectation wave or preparatory wave/. The clinical application of CNV is for the evaluation of the correlation of potential changes with changes in cognitive functions occurring in various diseases. Numerous studies reported recently have confirmed the applicability of CNV on the diagnosis of dementia, Parkinson's disease, epilepsy, schizophrenia, anxiety states, chronic pains, including migraine.

Anxiety Disorders↗

[Correlation between results of transcranial doppler ultrasonography and SPECT in the brain of patients with ischemic cerebral stroke].

Single photon emission computerized tomography /SPECT/ and positron emission tomography /PET/ are used presently for the study of the cerebral blood flow /CBF/. The cost of these procedures limits the possibility of their use and makes them available mainly in large and rich clinical centres. Transcranial Doppler USG has no such drawbacks. The purpose of the present study was analysis of a possible correlation between marker cumulation /in SPECT/ in the vascularization area of the middle cerebral artery /MCA/ and the parameters Vs, Vm, Vd, PI, RI, R of the PUSG-G examination of these arteries in 50 patients aged 48-79 years treated for ischaemic cerebral episodes. Brain SPECT examination was done with Apex-SP-6-HR gamma camera assessing the distribution of 99mTc HMPAO marker in the vascularization area of both MCA. PUSG-D examination was done with Tc-2-64 unit. In both MCA the systolic Vs, the mean velocity Vm, the diastolic velocity Vd, the Gosling pulsation index PI, the Purcelot resistance index RI and the velocity amplitude R were measured. The following conclusions have been reached: 1/ in patients with ischaemic cerebral episodes a significant correlation was found between cerebral SPECT findings and the PUSG-D parameters; 2/ reduced perfusion of the cerebral tissue was correlated with lower values of Vs, Vm, Vd, and R and with higher values of PI and RI; 3/ slight disturbances of perfusion found in SPECT were not reflected in changed PUSG-D parameters; 4/ the results justify the use of PUSG-D for indirect assessment of blood flow in the MCA.

Aged↗

[Use of transcranial doppler ultrasonography in patients with vascular dementia].

The aim of the study was the evaluation of the clinical usefulness of transcranial Doppler ultrasonography /TDU/ in patients with vascular dementia. The study was carried out in a group of 69 patients divided into two groups: group i of 32 patients aged 45-78 years, mean age 58.4 years with two or more ischaemic foci on TDU and dementia symptoms. The cases in this group fulfilled the criteria of dementia according to DSM-IV, ICD 10, MMS scale and Hachinski ischaemic scale. In TDU the following parameters were analysed: maximal velocity /Vmax/, minimal velocity /Vd/, mean velocity /Vmean/ of blood flow in the middle cerebral arteries, pulsation index /PI/ and resistance index /RI/. In group II the patients were divided into three subgroups according to ICD-10 criteria and localization of ischaemic foci: with cortical, subcortical and mixed lesions. The following conclusion have been drawn: 1/ the parameters of TDU could serve for differentiation of patients with vascular dementia; 2/ the PI and RI parameters in TDU are most valuable for diagnosis establishing; 3/ the transcranial Doppler ultrasonography is insufficient for differential diagnosis of dementia.

Aged↗

[Use of modified lateral nucleus pulposus herniation classification in low back pain].

Nucleus pulposus herniation is one of frequent causes in spinal pains. The necessity of undertaking of appropriate treatment, often surgical, requires early establishing of precise diagnosis. The traditional classification of herniations into central, centrolateral and lateral seems to be insufficiently precise, especially from the surgical point of view. For that purpose, the authors, following the classification of Volle et al., applied in their analysis the new classification into central and lateral nucleus pulposus herniae and discerning among the latter ones four types with strictly defined localisation: mediolateral, lateral with recess involvement, intervertebral foramen hernia, outside intervertebral foramen hernia. Seventy-two cases were analysed. Hernia was diagnosed by means of CT. Particular attention was given to the most external hernias, that is into and outside the intervertebral foramen. The more accurate method for the assessment of hernias and bone changes was in CT the Reconstruction in sagittal and frontal planes and also in oblique projections. The authors believe that the diagnosis of lateral nucleus pulposus hernias in low spinal area, particularly those with herniation into and outside the intervertebral foramen should be based on CT in appropriate reconstructions.

Adult↗

Electrophysiological investigations of the mild spinal cord injury in rats.

Somatosensory evoked potentials (SEPs) waveform recorded from the normal and injured spinal cord in rats were analyzed. A mild compression spinal cord injury was performed in two experimental models. The first model was used to assess the disappearance and the second one the return of the electrophysiological spinal cord function after injury. In the first experimental model typical changes in waveforms morphology from normal to isoelectric line during spinal cord compression were investigated. In the second model an isoelectric line was achieved by more severe but a shorter time of compression and the typical changes in SEPs morphology after decompression were described. Our evidence suggests that the spinal cord function disappears gradually during mild compression and can return early after decompression. The amplitude after decompression first improved and then gradually deteriorated which is probably caused by secondary insult. Experimental models are both effective and simple and may be used to evaluate the effect of treatment of spinal cord injuries.

Animals↗

[The evaluation of the usefulness of electronystagmography studies in Doppler's intracranial ultrasonography and brain stem evoked potentials in patients with vertigo].

The aim of the work was the evaluation of correlations between the electronystagmographic results examinations and Doppler's intracranial ultrasonography and brainstem auditory evoked potentials in patients with vertigo. The were 68 patients tested (39 women and 29 men) aged 34-68 years. The obtained results showed for the correlations between the electronystagmographic results examinations and Doppler's intracranial ultrasonography and brainstem auditory evoked potentials.

Adult↗

Elevated plasma atrial natriuretic peptide concentrations in hypertensive patients with acute myocardial infarction.

BACKGROUND: Atrial natriuretic peptide (ANP) has been extensively studied in cardiovascular disorders in recent years. Particular attention has been paid to the role of ANP in the pathogenesis of hypertension and congestive heart failure and in the neurohormonal response to myocardial infarction. However, no published data are available on the significance of ANP in hypertensive patients with acute myocardial infarction. METHODS: We studied the relationship between plasma ANP concentration and systolic blood pressure, diastolic blood pressure, left atrial dimension, left ventricular diastolic dimension and left ventricular mass index in patients with essential hypertension in the acute phase of myocardial infarction. Plasma ANP concentrations were determined at 0, 4, 8, 16, 24, 48 and 72 h after admission in 40 patients with a first myocardial infarction (18 hypertensive patients, group 1; 22 normotensive patients, group 2). Left atrial dimension and left ventricular diastolic dimension were assessed echocardiographically within the first 48 h of acute myocardial infarction. RESULTS: Maximum and mean plasma ANP values at 0, 4, 8, 16, 24, 48, and 72 h as well as mean ANP concentrations within the 72 h period were higher in group 1 than in group 2 (P < 0.001). Plasma ANP concentration, left atrial dimension (r = 0.59) and left ventricular diastolic dimension (r = 0.56) were positively correlated in both groups. CONCLUSION: Acute myocardial infarction is characterized by a more pronounced rise in plasma ANP concentration in hypertensive patients than in those without a history of hypertension. Plasma ANP concentration correlates with left heart chamber sizes.

Acebutolol↗

[Atrial natriuretic peptide level in acute myocardial infarction].

Concentration of atrial natriuretic peptide (ANP) was studied in acute myocardial infarction (AMI), its association with ventricular arrhythmias (VA), left ventricular dysfunction and infarct size. Plasma ANP concentrations were measured at time: 0, 4, 8, 16, 24, 48 and 72 hours after admission in 11 patients (pts) with first AMI, up to 6 hours after the first symptoms. Ventricular arrhythmia was assessed by 24 hour Holter monitoring, left ventricular dysfunction by echocardiography and infarct size by serial CK-MB measurement in first 72 hours of AMI. In subsequent measurements the average plasma concentration of ANP (mean +/- SEM) was elevated: 42.2 +/- 9.9, 35.3 +/- 12.5, 33.9 +/- 8.3, 42.3 +/- 8.3, 36.9 +/- 6.4, 60.7 +/- 9.3, 47.8 +/- 12.0 fmol/ml. The maximal plasma ANP concentration was significantly higher (p less than 0.01) in 4 pts with VA 4th grade acc. to Lown than in 7 pts without VA (102.6 +/- 17.9 vs 41.1 +/- 6.4). The maximal level of ANP--153.3 fmol/ml in a patient with paroxysmal supraventricular tachycardia was observed. There were no significant correlations between plasma ANP and infarct size, size of left atrium and contractility disturbances of left ventricle.

Adult↗

[A case of ventricular free wall rupture in acute myocardial infarction treated conservatively with success].

A sixty year old man developed clinical signs of pericardial tamponade on fifth day of acute myocardial infarction. An echocardiogram showed a pericardial effusion and rupture of left ventricular free wall. After pericardial puncture and four days pericardial drainage, the fissure of rupture was closed by formation of thrombus and pseudoaneurysm. After six weeks patient was discharged in good condition.

Drainage↗

[Tendinous cords in echocardiographic studies--occurrence, clinical significance].

Tendinous chords inside cardiac ventricles were found in 53 (5.6%) out of 954 individuals examined echocardiographically within one year. Only 30 individuals were further analysed. No marked pathology in the cardiovascular system was found. Tendinous chord was localized in the right ventricle in 7 individuals, in left ventricle in 21, and in both ventricles in 2 subjects. Ventricular arrhythmias were shown in 11 subjects (36.6%) with the aid of a 24-hour ECG monitoring with Holter's technique. They were of the II and IV stage of advancement according to Lown's classification. Ventricular rhythm disorders were seen in both subjects with tendinous chord within left ventricle (7 subjects) and in the right ventricle (4 subjects). Local diastolic disorders with no effect on the ejection fraction were noted in all subjects with false chord and ventricular rhythm disorders. Ventricular cardiac rhythm disorders are being observed in the subjects with the false chord located within the right or the left cardiac ventricle producing local diastole disturbances.

Adolescent↗

[Electrocardiographic and echocardiographic evaluation of cardiac changes in systemic scleroderma].

Cardiac abnormalities were studied using the clinical, electrocardiographic and echocardiographic methods in 66 patients with systemic scleroderma. Abnormal ecg was seen in 41 patients (62.1%), most frequently in form ventricular extrasystole (21.2%), incomplete block of the right bundle branch (12.1%), left ventricular and right atrial hypertrophy (10.6%) each, and the pattern suggesting the history of past myocardial infarction (7.6%). Abnormal echocardiographic results were found in 38 patients (57.6%). The most usual changes, differentiating that group from the controls, were: sluggish diastolic movement of the posterior wall of the left ventricle (40.7%), pericardial effusion (37.0%), elongation of the isovolumic relaxation time diastole phase (99.3 s.m.v. 81.1 ms, p less than 0.001) and right ventricular dilatation. There were no significant differences between the scleroderma and the control group as regards the indices of the contractility of the left ventricle: ejection fraction (EF), velocity of circumferential fibres shortening (VCF), diastolic size of the left ventricle and of the left atrium. The prevalence of the electrocardiographic and echocardiographic abnormalities in particular types of scleroderma (diffuse, acroscleroderma, severe acroscleroderma, CREST) was roughly similar: 50-76%. Finding of the impaired diastolic rather than systolic function of the left ventricle and of the similar prevalence of the cardiac abnormalities in the particular types of scleroderma is new and contradictory to the commonplace opinions.

Adult↗