Search PubMed⌕ Search

Biomedical subjects

M Jackowski

Publications and source records attributed to M Jackowski.

14 recordsLinked to original sources

Ultraviolet laser-induced fluorescence of human stomach tissues: detection of cancer tissues by imaging techniques.

BACKGROUND AND OBJECTIVE: The background for this work was several literature reports on applications of the fluorescence methods to detection and localization of human cancers. The objective of our study has been to investigate if such an approach could be applied for the detection of gastric cancers. STUDY DESIGN/MATERIALS AND METHODS: Our study was designed in such a way that spectrally resolved images of laser-induced fluorescence of human gastric mucosa were collected and assessed from a point of view of elaborating an algorithm allowing for a differentiation between malignant and premalignant lesions and areas of normal mucosa. The method involved exciting the autofluorescence with ultraviolet light (325 nm, He-Cd laser). The images were recorded in vitro in six regions of a visible spectrum using a cooled CCD camera. The material for study was 21 resected specimens for which altogether 72 surface areas were examined. RESULTS: The main result is the observation that a difference of the fluorescence intensities measured at 440 nm and 395 nm, both normalized to intensity measured at 590 nm, differs significantly for the tissues of interest. CONCLUSION: Using that difference as a diagnostic parameter, it was possible to classify malignant tumor tissues with a sensitivity of 96% and a predictive value of 42%, whereas the same approach applied to abnormal but not tumor stomach tissues gave values of 80%, and 98%, respectively.

Fluorescence↗

[Quality of life and long-term survival with intermittent self-ventilation in respiratory insufficiency caused by thoracic restrictive diseases].

BACKGROUND: Mortality and quality of life are to be assessed in patients with respiratory failure due to restrictive chest wall disease. Neither specific questionnaires, nor perspective studies are available. PATIENTS AND METHOD: In a retrospective analysis records of mortality and morbidity, physical and social activity, and duration of IPPV are reviewed. RESULTS: The group consists of 35 patients (mean age 56 +/- 12 years; 22 female, 13 male; 11 post tuberculosis, 24 kyphoskoliosis; IPPV duration 28.5 +/- 20.7 months). Five patients died, 3 of which during the first 4 months: In 3 death is related to respiratory symptoms, 1 is due to pulmonary embolism, 1 to disruption of aortic aneurysm. Hospitalisation is required by 12 patients in 20 instances with a mean duration of 14.2 days. Respiratory symptoms are the cause in 13 instances, special difficulties are met with occlusion of tracheostoma in 3 patients. Professional activity is performed by 14 of the 21 patients < 60 years old. Physical activity is severely reduced in 4 patients, while it is mildly to moderately compromised in 26. Seven of all patients need supplemental oxygen. CONCLUSION: In respiratory failure due to restrictive chest wall disease treatment with IPPV seems to improve long-term survival and to enhance quality of life.

Adult↗

[Diaphragmatic paralysis and respiratory insufficiency].

BACKGROUND: Phrenic nerve palsy leads to disfunction of the main respiratory muscle. With bilateral palsy dyspnoea in the supine body position will typically occur. With one-sided lesion symptoms will only appear when a second pulmonary disease is present. PATIENTS: We refer of 6 patients with bilateral and 5 with unilateral diaphragmatic paresis. In 3 patients neuralgic shoulder-arm-amyotrophy was diagnosed, in further 4 there was suspicion of it. Amyotrophic lateral sclerosis developed in 2 after 4 respectively 8 months. In 1 case a cervical operation led to palsy, mediastinitis in 1 case. Lung function tests showed a restrictive pattern, especially in bilateral palsy. RESULTS: Vital capacity was reduced by almost 50% respectively 25% in the supine body position. Mouth occlusion pressure reduction was apparent. Near normal to marked hyperkapnia developed in bilateral paresis. In 5 cases non-invasive intermittent ventilation is instituted (2 volume controlled, 3 pressure supported). Two patients died (1 patient with amyotrophic lateral sclerosis after 13 months, 1 with malignant pleurisy after 4 months). Three patients continued non-invasive intermittent ventilation since 14 to 64 months.

Adult↗

[Intravascular ultrasound in preoperative diagnosis of central bronchial tumors--initial clinical experiences].

In the course of preoperative diagnosis, intravasal sonography for tumour imaging was conducted in three patients suffering from central bronchial carcinoma. The catheters of 6.0 or 4.8 French diameter were advanced in each case after pulmonary angiography via the left or right pulmonary artery up to the tumour area. Endosonographic tumour imaging was compared with the findings of the other preoperative diagnostic measures and in two cases with intraoperative and postoperative findings. The vascular walls of the central pulmonary arterial segments showed sonographically no typical three-layer structure. In all cases, however, tumour infiltration was showed up by disappearance of the vascular wall reflexes in the relevant pulmonary artery branches. Visualisation of the mediastinal pulmonary artery segments or of the main stem of the pulmonary artery is difficult with the wire-guided catheters used, since these cannot be stabilised in the centre of the vessel. Development of suitable catheters with low-frequency transducers and greater depth of penetration is imperative especially for the diagnostically important visualisation of the surrounding mediastinal structures.

Adenocarcinoma↗

[The echocardiographic demonstration of a right atrial thrombus and its embolization into the lung].

A 43-year-old man was hospitalized because of extensive bilateral pulmonary tuberculosis. After several weeks of tuberculostatic treatment--at first applied orally, then because of nausea and vomiting parenterally via a central venous catheter--he acutely developed nocturnal dyspnoea and symptoms of shock requiring artificial ventilation. Echocardiography demonstrated dilatation of the right ventricle and a large floating thrombus in the right atrium. During the examination complete displacement of the worm-like thrombus into the pulmonary artery was observed echocardiographically. Despite anticoagulation and immediate operation the patient died 2 days later of protracted shock. The thrombus was found to have been formed in the superior vena cava after placement of the central venous catheter.

Adult↗

[Evaluation of an anamnesis questionnaire for the diagnosis of sleep apnea in patients with chronic diseases of the respiratory organs].

In a Rehabilitation Clinic for Diseases of the Respiratory Organs we examined 497 male patients aged 45.9 +/- 11.1 years with a relative weight of 109 +/- 16.7% who were suffering from chronic diseases of the respiratory tract (66.2% chronic bronchitis, 33.8% asthma bronchiale, 49.6% obstruction of the respiratory tract). They were subjected to a detailed physical examination and were given an anamnestic questionnaire for the purpose of diagnosing sleep-related respiratory disturbances (Siegrist et al., 1987). In addition, whole body plethysmography was performed in all patients as well as a pulse-oximetric examination during night sleep. Using factor analysis, it was possible to extract 5 factors from the 23 items of the anamnesis questionnaire. With these 5 factors, 60.5% of the total variance could be explained. These factors describe: 1. Dyspnoea (35.3%); 2. Vigilance (8.5%); 3. Sleep disturbances (6.3%); 4. Headache (5.8%) and 5. Snoring (4.7%). Different factor patterns are seen for different groups of patients. In patients suspected of an obstructive sleep apnoea syndrome, however, it will always be necessary to perform further stage-wise diagnosis to safeguard the diagnosis.

Adult↗

[Effect of chronic inhaled pollutants (cigarette smoke) on trans-epithelial measured potential difference of nasal mucosa in the human].

The transepithelial potential difference of the mucosa of the nose is appreciably higher in non-smokers than in smokers with a moderate to heavy cigarette consumption. This reduced potential difference in response to chronic inhalation to noxae (cigarette smoke) is a marker for the change in the integrity of the mucosa of the nose, and may possibly be considered to be representative of the rest of the respiratory epithelium of the bronchial system.

Adult↗

[The significance of vasoactive intestinal polypeptide (VIP) in diagnosis of sleep apnea syndrome].

Vasoactive intestinal polypeptide (VIP) is a neurotransmitter of the non-adrenergic and non-cholinergic system (NANC). It has been detected in many organs, including the airways, central and peripheral nervous system, the blood, and CSF. As a result of neuronal overflow, vagal stimulation leads to an elevation of VIP levels in the plasma. VIP leads to the activation of adenyl-cyclase, and thus to elevated cAMP in cells bearing VIP receptors. In 25 patients (24 males, 1 female) with a mean age of 50.3 +/- 9.9 years, and a Broca Index of 134.5 +/- 27.0%, plasma VIP was measured in the morning under conditions of fasting with the aid of an RIA assay (Incstar). Eleven patients (mean age: 49.4 +/- 10.1 years, Broca: 130 +/- 27.0%) had fewer than 100 episodes of apnea during nocturnal sleep (apnea/hypoapnea index 4.4 +/- 4.8). At 6.3 +/- 1.6 pcmoll-1, plasma VIP was markedly lower than that measured in 14 patients (mean age: 51.0 +/- 10.0 years, Broca: 138 +/- 28%) with the sleep apnea syndrome (apnea/hypopnea index 58.5 +/- 24.7 (means = 11.0 +/- 3.0 pcmoll-1, p less than 0.001). A significant correlation was found between the apnea episode occurring every night, and the VIP values (r = 0.64; y = -133 + 40 x VIP) measured in the plasma. The VIP measured in the plasma would appear to be a highly sensitive and highly specific indicator of the appearance of episodes of apnea during nocturnal sleep.

Adult↗

[Study of the prevalence of sleep apnea syndrome in patients with chronic diseases of the respiratory organs using pulse oximetry and polysomnography].

In the literature, depending upon the group of subjects investigated and the diagnostic criteria applied, the prevalence of the sleep apnea syndrome (SAS) is reported to be between 1 and 10%. In the present study, 220 nonselected male patients (age range: 45.1 +/- 11.4 years, Brocca index 109.0 +/- 18.0%, 147 cases of chronic bronchitis, 65 of bronchial asthma, 8 with other diseases of the airways, 44.1% obstructive ventilation disturbances, 41.8% smokers) were investigated. As a screening method, nocturnal monitoring of oxygen saturation with the aid of a digital pulse oximeter (Draeger) was carried out. On average, 65.4 +/- 136.5 cases of desaturation to less than 90% SaO2/8 hours sleep were observed. In 48 patients with a Brocca index of more than 120%, desaturations at 156.1 +/- 244.5 were significantly more frequent than in 172 patients with a low relative weight (40.2 +/- 67.0, p less than 0.0001). Forty-eight patients (21.8%) revealed more than 80 episodes of SaO2 drops per night. Twenty-two patients were submitted to polysomnographic investigation. In 13 patients--6% of the overall group--who had more than 100 episodes of apnea/hypopnea (AHI 47.2 +/- 30.1), a sleep apnea syndrome was demonstrated.

Adult↗

[Personality markers in patients with sleep apnea syndrome].

In addition to the well-known medically oriented examination procedures and forms of treatment of sleep apnea, we are also interested in the psychological aspects of this pathological condition. Against the background of our experience of patients treated with nCPAP--here we have observed, among other things, an increase in general activity--we investigated the question as to whether typical personality traits are to be observed among persons suffering from sleep apnoea. As a psychodiagnostic procedure, the Freiburg personality inventory (FPI-R) was employed in the following persons: a) Persons with diagnosed sleep apnea, b) persons with unconfirmed suspected sleep apnea, c) persons with diagnosed chronic bronchitis. An initial consideration of the results reveals an unremarkable personality profile of the person with SAS who, however, in comparisons with other groups does reveal certain peculiarities. Although the results presented here do not permit any reliable specific psychodiagnostic statement to be made with the aid of the procedure employed, in several points they do provide clues as to features that should be subjected to a differential investigation.

Arousal↗