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Biomedical subjects

J Wojcik

Publications and source records attributed to J Wojcik.

36 records · Page 2Linked to original sources
PubMed1992

Pharmacokinetics and fibrin specificity of alteplase during accelerated infusions in acute myocardial infarction.

Pharmacokinetics and fibrin specificity of alteplase (recombinant tissue-type plasminogen activator) were determined in 10 patients with acute myocardial infarction undergoing an accelerated infusion regimen during the alteplase/anistreplase patency study (TAPS). Fifteen milligrams of alteplase was administered as an intravenous bolus injection, followed by infusions of 50 mg over 30 min and 35 mg over a further 60 min. Mean steady state plasma concentrations of alteplase during the initial 30 min were 3.2 +/- 0.84 micrograms/ml, measured immunochemically, and 2.1 +/- 0.23 micrograms/ml, measured using a functional activity assay. These values were 45% and 51% higher, respectively, than those during the standard infusion schedule (p less than 0.01). However, the predominant plasma half-life determined by model fitting based on either assay (3.3 to 3.5 min) was unaltered compared with the standard regimen. Maximal concentrations of fibrin and fibrinogen degradation products were 5.1 +/- 2.2 and 1.9 +/- 1.1 micrograms/ml, respectively. Plasminogen decreased to 70% and alpha 2-antiplasmin to 35% of values before infusion. The results indicate that 1) improved coronary patency rates during "front-loaded" infusions can be rationalized in terms of higher plasma concentrations of both free and immunoreactive alteplase, 2) kinetic variables are comparable with those of other dosing strategies, and 3) fibrin specificity is not diminished relative to that of the standard infusion regimen.

Aged↗
PubMed1991

Successful surgical management of left ventricular free wall rupture in the course of myocardial infarction.

The case of a 49-year-old patient is described who presented with cardiogenic shock and electrocardiographic signs of an inferolateral Q-wave infarction, and who received systemic lysis with anisoylated plasminogen streptokinase activator complex (Eminase). After coronary angiography had revealed only peripheral occlusion of a posterolateral branch of the left circumflex coronary artery, a pericardial effusion surrounding both right and left ventricular cavity was identified by echocardiography and was successfully drained via an inferior pericardiotomy with an immediate rise of blood pressure. Upon thoracotomy myocardial rupture was detected in the infarct area and was closed with mattress sutures. A total of 39 cases of successful surgical repair of myocardial free wall rupture reported in the literature is discussed. The mean age of patients was 59.6 +/- 1.3 years. Posterior and anterolateral infarctions were the preferred locations of myocardial rupture. Rupture occurred with a mean delay of 5.0 +/- 1.0 days after the onset of clinical infarct signs. Among patients saved by surgical means were 33 males and 6 females.

Cardiac Catheterization↗
PubMed1991

[Effect of thrombolytic therapy in acute myocardial infarct on incidence of ventricular late potentials].

The aim of thrombolytic therapy for acute myocardial infarction is reperfusion of the infarction-related vessel. Ventricular late potentials detected by signal averaging have been demonstrated to be related to slow and inhomogeneous conduction within damaged cardiac tissue. In 75 patients with first myocardial infarction the effect of thrombolysis on ventricular late potentials was studied. Reperfusion of the infarction-related vessel could be demonstrated by coronary angiography in 53 (71%) patients. In 22 patients (29%) there was no reperfusion. In the 53 patients with successful thrombolysis the incidence of late potentials was significantly lower (9%) than in the 22 patients without reperfusion (50%). The lower incidence of late potentials may demonstrate improved ventricular electrical stability.

Adult↗
PubMed1990

[Percutaneous transluminal coronary angioplasty in patients over 75 years old with acute myocardial infarct or unstable angina pectoris].

Both increasing frequency and technical improvements of percutaneous transluminal coronary angioplasty (PTCA) have focussed attention on possible applications of PTCA in elderly patients with coronary artery disease. From January 1986 to June 1989, among 1872 patients treated with PTCA in our hospital, 42 patients (2.3%) were 75 or more years old. Of these patients, 14 presented with unstable angina, 28 patients suffered from acute myocardial infarction. PTCA was performed on stenoses of left anterior descending artery (43%), circumflex coronary artery (18%), and right coronary artery (39%), respectively. In patients with unstable angina, PTCA in 81% could reduce diameter stenoses of culprit lesions to 50% or less. 43% of patients with acute myocardial infarction had received previous thrombolytic therapy with streptokinase or urokinase applied either systemically or intracoronarily. On cardiac catheterization, 39% of patients presenting with acute myocardial infarction showed total occlusion of the infarct-related vessel. In 75% of patients with acute myocardial infarction, after PTCA, patency of the infarct-related artery (diameter stenoses 50% or less) was observed. In-hospital mortality of patients with acute myocardial infarction subjected to PTCA was 10%, two patients dying in prolonged cardiogenic shock, one in septic shock. In 20% of cases, coronary dissection was observed after PTCA. Non-Q-wave infarction developed in one patient. Three patients had a peripheral vascular complication, and in one patient a transient ischemic attack was observed. No severe catheter-related complications occurred after thrombolytic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1990

[Thrombolysis in resuscitated patients with pulmonary embolism].

A retrospective analysis is presented of data from 17 patients with proven pulmonary embolism (10 women, 7 men, mean age 50.8 [18-76] years) who had received short-term high dosage thrombolytic therapy shortly before or after (less than 24 h) undergoing mechanical resuscitation. The mean duration of resuscitation was 76 (20-160) minutes. Two patients had already been resuscitated half an hour and one hour, respectively, before the commencement of thrombolysis. In nine other patients thrombolysis was commenced during resuscitation. Hospital mortality in the latter group was amazingly low (four of nine patients died). In contrast, out of six patients who required resuscitation shortly after the commencement of thrombolysis, not one survived. Haemorrhagic complications occurred in four out of the 17 patients, but only in two were they directly attributable to the resuscitation: one female patient developed an extensive haematoma in the sternal region, and two days after resuscitation another female patient had a haemorrhage into the capsule of the liver during thrombolytic therapy which had been continued because of leg vein thrombosis. In the light of these results it seems justifiable, even on mere clinical suspicion of pulmonary embolism, to initiate short-term high dosage thrombolytic therapy during or after resuscitation.

Adolescent↗
PubMed1990

[Spontaneous coronary artery dissection: a rare cause of myocardial infarct].

The case of a 52-year-old female is presented who suffered from myocardial infarction with a prolonged course of symptoms. The angiographic examination revealed a spontaneous dissection of the right coronary artery without evidence for atherosclerotic coronary artery disease. Under medical treatment no further complications occurred. Control angiography showed a spontaneous improvement of the dissection. The characteristic clinical features of this case are compared with the literature data on angiographically visualized spontaneous coronary artery dissections.

Aortic Dissection↗
PubMed1989

Ergoloid mesylates and ECT.

Amnesia is the most common adverse effect among patients receiving electroconvulsive therapy. In a double-blind pilot study, patients receiving bilateral ECT were pretreated with ergoloid mesylates (N = 5) or placebo (N = 5). Consistent with the hypothesis that ergoloid mesylates might protect against ECT-associated amnesia, nonsignificant trends on some memory tests showed better performance for patients receiving active treatment. Unexpectedly, patients treated with ergoloid mesylates had a significantly better antidepressant response.

Amnesia↗
PubMed1988

BRS Colleague MEDLINE end user training follow-up survey.

The amount of recent literature describing end user training programs is substantial, yet there are few reports evaluating the effectiveness of such training. This article reports on a follow-up survey of the first seventy-five trainees of a four-hour BRS Colleague MEDLINE training program at the Health Sciences Library of East Carolina University. The 90.7 percent response rate to the questionnaire provided information about both those who performed searches and those who had not. It indicated how trainees felt about their training, their ability to perform searches or reason for not performing searches, and types of additional training the trainees desired. Survey results are discussed in terms of effectiveness of the training for the end user with infrequent search needs, possible modifications to improve the effectiveness of the training, and possible alternatives to BRS Colleague MEDLINE.

Attitude of Health Personnel↗
PubMed1982

Interaction of dietary protein with cellulose in the adaptation of caloric dilution by weaning rats.

The adaptive response of food intake to increasing levels of dietary cellulose was studied in weanling rats fed limiting amounts of dietary protein of different qualities. At low levels of dietary cellulose, the food intake depends on protein quality. As the cellulose levels were increased, the diet and gross energy digestibilities diminished, yielding diets with lower digestible energy contents. The rats fed the higher quality protein were able to compensate for this caloric dilution, increasing their food consumption enough to keep constant their digestible energy intake. The animals fed a lower quality protein, however, were unable to make this adaptive increase in food intake. As a result, although gross food intake remained stable, cellulose constituted an increasing proportion of it and the digestible energy consumption of these animals diminished. Water consumption in this trial appears to reflect the animal's digestible energy intake rather than cellulose consumption. The above observations may be considered as an indication that a smooth regulation of the energy intake occurs only with a complete or non-deficient diet and that deficient, abnormal or unusual diets upset this process. In the present experimental situation, when dietary protein is inadequate, the animal can no longer make appropriate compensatory increases in its food consumption to keep its digestible energy intake constant.

Adaptation, Physiological↗
PubMed1981

Method of addition of cellulose to experimental diets and its effect on rat growth and protein utilization.

The growth response of rats to experimental diets limiting in protein was used to evaluate two modes of addition of fiber. The first mode (trial A) used the more conventional approach of substituting cellulose for starch. The second mode (trial B) proceeded by total diet dilution, by which cellulose was added to a cellulose-free stock diet. Rats fed both types of diets compensated for the energy dilution and their digestible energy intake did not change markedly. However, both protein intake and growth increased with rising dietary cellulose levels in trial A and the protein efficiency ratio (PER) decreased. These did not change in trial B, except at the highest cellulose level, where growth and PER tended to decrease. Not only did the total diet digestibility and gross energy digestibility diminish upon the addition of cellulose to the diet, but the apparent protein digestibility also decreased in response to increasing dietary cellulose. We concluded that, in the design of experiments using high-fiber diets, careful consideration should be given to the effect which the method of dietary fiber addition has on the effective concentration of nutrients in the non-fiber portion of the diet and to the effect which variations in the parameter might have on nutrient utilization or biological responses to them. Our results indicate that, under conditions where protein is in limiting amounts in the low-fiber diets, total diet dilution is the more appropriate mode of dietary fiber addition. This conclusion may apply to other nutrients as well, but that remains to be proved.

Animals↗
PubMedDate not supplied

CDP-choline for the treatment of tardive dyskinesia: a small negative series.

Based on the cholinergic-deficiency hypothesis of tardive dyskinesia (TD), we administered cytidine diphosphoryl choline (CDP-Choline) (a naturally occurring biochemical intermediary in the synthesis of phosphatidylcholine), 500 mg twice a day orally, to four women and one man with TD for 2 to 8 weeks in a double-blind, placebo-controlled crossover trial. Although the small sample size provides only limited power to detect a treatment effect, there was no evidence of efficacy, adverse effects, or changes in psychopathology.

Adult↗