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Biomedical subjects

J Walecki

Publications and source records attributed to J Walecki.

At least 55 records · Page 3Linked to original sources

[A case of pituitary stalk tumor diagnosed with magnetic resonance (MRI)].

Authors present a case of 28-year old female with anterior hypopituitarism and diabetes insipidus, with properly functioning anterior pituitary cells as showed by means of measuring pituitary hormones in response to neurohormones i.v. injections. Magnetic resonance imaging revealed neoplastic tissue in the pituitary stalk destroying supraopticohypophysial and paraventriculohypophysial tracts, as well as portal blood system, thus preventing release of vasopressin and these hypothalamic neurohormones from accessing anterior pituitary.

Adult↗

New long-acting bromocriptine (Parlodel MR and Parlodel LAR) in the treatment of pituitary tumours with hyperprolactinemia.

In order to assess the efficacy and tolerability of new long acting bromocriptine: Parlodel MR (oral form) and Parlodel LAR (injectable form suitable for repeatable administration) 40 patients (29 women and 11 men) with pituitary tumours with hyperprolactinemia (PRL 70 micrograms/l) were investigated in a double blind study. Patients were divided into 2 groups of 20. In the first group Parlodel R or Parlodel MR in equivalent doses was given, the other group was administered Parlodel R or Parlodel LAR. During the next 6 months 20 patients were treated with Parlodel MR and the other 20 with Parlodel LAR. In all patients pituitary and peripheral hormones, CT scan and visual fields were examined before and after 28 days of bromocriptine treatment. During the next six months 20 patients were treated with Parlodel MR while the other 20 with Parlodel LAR. Serum PRL fell in all patients and values in the normal range were obtained in 36 patients. In 30 out of 35 patients with signs of pituitary tumour in CT scan, a significant tumour shrinkage was observed. Most patients achieved considerable clinical improvement: disappearance of galactorrhoea, resumed menses in women, increased potency in men. There were no difference in efficacy in Parlodel R, Parlodel MR and Parlodel LAR, but in the case of Parlodel LAR the least number of side effects was found. Treatment with long acting bromocriptine-Parlodel MR and LAR of patients with pituitary tumours with hyperprolactinemia is an efficacious, safe and better tolerated method than Parlodel R treatment.

Adult↗

Mixed pituitary tumours--effects of bromocriptine treatment: Parlodel MR and Parlodel LAR.

Majority of pituitary tumours secrete one of the named hormones: PRL, GH, ACTH, proopiomelanocortine, alpha and beta subunit of TSH, LH, and FSH. Some of those tumours secrete two or more hormones. The aim of this study was to determine the effect of bromocriptine (Parlodel MR and LAR) upon secretion of hormones and tumour size in 10 patients with mixed pituitary tumours. In all patients pituitary and peripheral hormones, CT scan and visual fields were examined before and after treatment with bromocriptine: Parlodel MR and LAR. Bromocriptine treatment decreased PRL secretion in all 10 patients; GH--in all 6 in whom it was increased; TSH--in 2, FSH--in 2 and alpha-subunit in all 6 in whom they were increased. In 5 patients treatment resulted in shrinkage of the tumour mass by 20 to 35%. In all examined subjects clinical improvement was achieved. Our results demonstrate that bromocriptine (Parlodel MR and LAR) is very effective and well tolerated in the treatment of patients with mixed pituitary tumours particularly those with hyperprolactinemia.

Adult↗

Measurement of bone mineral density (BMD) with quantitative computed tomography (QCT) in postmenopausal osteoporosis: effect of estrogen.

UNLABELLED: To determine the efficacy of the estrogen replacement therapy (ERT) on the bone mineral density (BMD) measured with quantitative computed tomography (QCT) in postmenopausal osteoporosis 16 women aged 46-72 were examined. They were divided into two groups: 8 women treated with conjugated estrogens (Group I) and 8 who did not received ERT (Group II). In all 16 patients the serum hormonal concentrations (LH, FSH and estradiol) were measured with radioimmunological methods. The bone densitometry was performed in all of them using the single-energy computed tomography (QCT) with the computer Picker 1200. Bone mineral density was measured in three lumbar vertebra (L1-L3) and expressed in milligrams K2HPO4 per ml. The bone mineral density (BMD) was statistically significantly higher in the estrogen treated group (Group I) in every vertebra compared with that of controls (Group II). The serum FSH concentration was statistically significantly lower in the ERT group (Group I) and a statistically significant correlation between FSH level and average BMD (Lmean) was present. IN CONCLUSION: 1. the ERT is very efficacious in preventing bone loss in postmenopausal women; 2. measurement of BMD in lumbar vertebra L1 or L3 may be a sufficiently reliable and accurate, cost-effective and time-saving method of screening for osteoporosis; 3. the serum FSH determination seems to be useful in monitoring of the estrogen therapy for postmenopausal osteoporosis.

Aged↗

[The so-called stroke headache].

Sudden violent headache occurring for the first time in life suggests subarachnoid haemorrhage and requires diagnostic management. In 20 cases the authors failed to find blood in cerebrospinal fluid, but in 8 cases the protein level was raised. The patients were examined again after 2-10 years, and had control neurological examination and CT of the brain. In half the cases similar headaches returned after various time periods, and haemorrhage was again ruled out. In all patient chronic headaches of lower intensity developed. Control CT examination showed in 7 cases scars or atrophy of brain tissue. It is difficult to qualify such headaches as migraine and other known types of headache. Recently in the literature a new name has been coined for them--thunderclap headaches, and some authors regard them as a sign of minor intracranial haemorrhage. CT changes, raised protein level in cerebrospinal fluid, and the type of pain may suggest haemorrhage. The usefulness of cerebral arteriography in such patients should be considered. We propose the name of stoke headache for suggesting the cause and special management.

Brain↗

Evaluation of oedema spreading and intracranial volume reserve using CT image numerical analysis.

Using the cold lesion model vasogenic oedema was produced in 8 cats. The intracranial volume reserve was evaluated applying CT image numerical analysis (CTINA). Summarizing all voxels corresponding to CSF and brain tissue in 8 CT slices, the brain/CSF ratio was computed. The animals were studied at different time intervals after the lesion (2 h, 4 h, 6 h) then sacrificed and the spreading of oedema was estimated based on the BBB disturbances. The brain/CSF ratios varied from mean value of 0.043 in control animals to mean values of 0.022 in animals 6 hours after the lesion. The CTINA method was found very useful as a noninvasive screening method to study brain oedema development with a promising application in clinical practice.

Animals↗

Application of dynamic computed tomography scan and computed tomography densitometry in the evaluation of brain volume enlargement.

Cats with brain cold injury and epidural balloon compression with sudden decompression were used as models of vasogenic or ischemic edema and vasoparalysis of the brain vessels. Dynamic CT scan and CT densitometric studies were performed to diagnose and differentiate between brain edema and vasoparalytic changes. The CT methods were found to be useful in CBF and edema zone estimation. The correlation of CT scan and CT densitometry enabled us to evaluate the degree of autoregulation disorders and can be also applied in clinical investigations.

Blood-Brain Barrier↗

[Computerized tomography of the head in patients with epilepsy].

A detection of structural changes in the brain of epileptic patients is of importance to the choice of therapeutical management. Incidence and character of lesions in CT-scans of the skull were analysed in the random group of epileptic patients. Normal areas in CT-scans were prevailing in young patients. Atrophic lesions to the brain increased with the patients' age and duration of the disease. Normal results were obtained in post-traumatic epilepsy and that of unknown etiology similarly to atrophic lesions whereas localized lesions were found in all patients with cerebral tumors. Partial epilepsy, especially of short duration, was characterized by high incidence of localized lesions. Normal EEG records were rare in patients with localized lesions detected with CT-scans whereas normal CT-scans may be related to abnormal EEG record. Presence of the localized lesions in some patients and atrophic areas did not limit clinical results of monitored therapy. CT-scanning of the skull should be performed in case of all patients with epilepsy even if there are no significant changes in EEG records or clinical status.

Adolescent↗

[Clinical, CT and electrophysiologic studies of alcoholics with special reference to the cerebellum].

Comprehensive clinical examinations and laboratory investigations were carried out in 20 alcoholics (Group III according to Jellinek's classification) with particular reference to the cerebellum. Clinical cerebellar signs were found in 4 cases, and in 3 of them atrophic changes of the cerebellum and cerebrum were demonstrated in CT examinations, and in 3 electrophysiological changes compatible with neuropathy were found. Evoked auditory potential from the brainstem was changed in 12 cases, which might be explained as impairment of the cerebellar function. In 12 cases signs of polyneuropathy were disclosed, in 5 of them they were evident clinically and electrophysiologically, and in 7 they were found only in EMG. Changes in somatosensory and visual evoked potentials were less evident, but in connection with abnormalities in other investigations they suggested presence of diffuse or disseminated nervous system damage. These investigations suggest that cerebellar signs in alcoholics are not isolated and are a manifestation of a more generalized damage to the nervous system.

Adult↗

[Wegener's granulomatosis with adrenal gland involvement].

A case of Wegener's granulomatosis in a female with characteristic three organ involvement (upper airway, lung, kidneys) is presented. The changes were also seen in the suprarenal glands. This merits attention due to the fact that such a localization was never previously published. Diagnostic problems were caused by pulmonary changes imitating lung metastasis. The patient was treated three years with prednisolone and cyclophosphamide. Complete remission was seen in the lungs and kidneys, and regression of the left suprarenal involvement was observed.

Adrenal Gland Diseases↗

Cerebellar atrophy diagnosed by computed tomography and clinical data.

The diagnostic relevance of computed tomography (CT) in the classification of cerebellar atrophy or degeneration is unclear. Twenty-one patients with cerebellar atrophy at CT were studied and the findings were correlated to clinical data. Based upon such data the material was divided into two groups. In the first group (12 patients), with signs of cerebellar deficiency, 6 cases presented familial hereditary ataxia, and olivopontocerebellar atrophy of the Menzl type, 3 ataxia telangiectasia (Louis-Bar syndrome), 2 olivopontocerebellar atrophy of the sporadic type, and 1 adrenoleukodystrophy. In the second group (9 patients), without cerebellar deficit, cerebellar atrophy was found only occasionally. In all of them, there was cerebral atrophy. Clinically manifest cerebellar deficiency and cerebellar atrophy as evident at CT was mainly found in patients with familial genetic disorders. Cerebellar and/or vermian atrophy without clinical signs of cerebellar deficiency were observed only occasionally and were not specific.

Adolescent↗