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Biomedical subjects

M Kowalski

Publications and source records attributed to M Kowalski.

At least 37 records · Page 2Linked to original sources
PubMed2002

Detection of Helicobacter pylori specific DNA in human atheromatous coronary arteries and its association to prior myocardial infarction and unstable angina.

BACKGROUND: Chronic infections have been proposed to play a role in the aetiology or progression of atherosclerotic plaques. Increased risk of coronary artery disease has been suggested in patients seropositive for Helicobacter pylori. AIM: To analyse coronary specimens in patients with severe (coronary artery disease) for Helicobacter pylori specific DNA. PATIENTS AND METHODS: Atherosclerotic plaques were obtained in 46 consecutive patients (9 female, 37 male, mean age 62.7+/-9.17 years) during coronary bypass procedures. Serum was analysed for IgG -/cagA-antibodies specific for Helicobacter pylori. Polymerase chain reaction and sequence analysis were used to identify bacterial DNA. Coronary artery biopsies from 19 autopsies without coronary artery disease were examined as a control group. RESULTS: Of the 46 coronary artery disease patients, 32 (69.6%) were Helicobacter pylori seropositive. Positive results for Helicobacter pylori DNA showed 18 seropositive and 4 seronegative (with anamnesis of eradication therapy). A total of 22 patients (47.8%) of the coronary artery disease group but none of controls revealed positive DNA. In the coronary artery disease group, a correlation between DNA presence and prior myocardial infarction (p=0.008) and unstable angina (p<0.001) was found. CONCLUSION: Identification of DNA in atherosclerotic plaques of patients with severe coronary artery disease supports the hypothesis that Helicobacter pylori infection may influence the development of atherosclerosis. Our results may indicate an direct involvement of Helicobacter pylori in the progression and instability of plaques in these patients.

Aged↗
PubMed2001

Observation of high-energy neutrinos using Cerenkov detectors embedded deep in Antarctic ice.

Neutrinos are elementary particles that carry no electric charge and have little mass. As they interact only weakly with other particles, they can penetrate enormous amounts of matter, and therefore have the potential to directly convey astrophysical information from the edge of the Universe and from deep inside the most cataclysmic high-energy regions. The neutrino's great penetrating power, however, also makes this particle difficult to detect. Underground detectors have observed low-energy neutrinos from the Sun and a nearby supernova, as well as neutrinos generated in the Earth's atmosphere. But the very low fluxes of high-energy neutrinos from cosmic sources can be observed only by much larger, expandable detectors in, for example, deep water or ice. Here we report the detection of upwardly propagating atmospheric neutrinos by the ice-based Antarctic muon and neutrino detector array (AMANDA). These results establish a technology with which to build a kilometre-scale neutrino observatory necessary for astrophysical observations.

Journal Article↗
PubMed2001

Event-by-event fluctuations of the Kaon-to-Pion ratio in central Pb+Pb collisions at 158 GeV per nucleon.

We present the first measurement of fluctuations from event to event in the production of strange particles in collisions of heavy nuclei. The ratio of charged kaons to charged pions is determined for individual central Pb+Pb collisions. After accounting for the fluctuations due to detector resolution and finite number statistics we derive an upper limit on genuine nonstatistical fluctuations, which could be related to a first- or second-order QCD phase transition. Such fluctuations are shown to be very small.

Journal Article↗
PubMed2001

Transvenous closure of moderate and large secundum atrial septal defects in adults using the Amplatzer septal occluder.

The aim was to determine the feasibility of using the Amplatzer septal occluder for closure of moderate and large secundum atrial septal defects in adults. Fifty patients aged 16-76 years (mean +/- SD, 40 +/- 15.5), underwent successful device implantation. Flow ratios of 1.4-8.5 (mean +/- SD, 2.6 +/- 1.6) were calculated. The defects were: centrally placed (n = 31), antero-superior with partial or total deficiency of aortic rim (n = 19), multiple (n = 3) and with aneurysmal septum (n = 23). They measured 4-25 mm (median 14) on echocardiography and balloon sized 7-31 mm (median 19.5). Devices of 7-34 mm (median 20) were implanted. Patient follow up for 1 month (50/50 patients), 3 months (40/50) and 12 months (13/50), achieved respective rates of 90%, 92% and 98% of complete occlusion. In one patient a transient atrioventricular block (2:1) developed, and one had a transient STT elevation. One female had an episode of 30 min loss of vision over the lateral aspect of the left eye 3 months after implantation. In conclusion, transvenous occlusion of secundum atrial septal defects with the Amplatzer septal occluder in adults is safe, and can be performed without significant complications. Large defects, defects with a very deficient or absent aortic rim, defects with an aneurysmal septum as well as some multiple defects can be closed with an almost 100% early complete occlusion rate. This makes the procedure an alternative to surgery for selected adult patients.

Adolescent↗
PubMed2001

Doppler myocardial imaging. A new tool to assess regional inhomogeneity in cardiac function.

In echocardiography, there is still a need for a better tool to quantify regional myocardial function. Doppler myocardial imaging (DMI) allows the calculation of local myocardial velocity profiles for segmental motion in both the radial and longitudinal direction. From the local velocity profile data, 1-dimensional regional myocardial strain rates (SR) and strain (epsilon) can now be calculated. These new deformation indices more accurately define regional function compared to velocities as they are independent of overall heart motion. This paper will define the normal segmental velocity, SR and epsilon profiles and their relationship with global mechanical event markers. It will also define the changes in local velocity and deformation characteristics, which are induced by disease and the current experimental and clinical status of this new quantitative ultrasound tool.

Echocardiography, Doppler↗
PubMed2001

Can natural strain and strain rate quantify regional myocardial deformation? A study in healthy subjects.

Strain rate (SR) and strain (epsilon) have been proposed as new ultrasound (US) indices for quantifying regional wall deformation, and can be measured from color Doppler myocardial data by determining the local spatial velocity gradient. The aim of this study was to define normal regional SR/epsilon values for both radial and longitudinal myocardial deformation. SR/epsilon profiles were obtained from 40 healthy volunteers. For radial deformation, posterior left ventricular (LV) wall SR/epsilon were calculated. For longitudinal, they were determined for basal, mid- and apical segments of the 1. septum; 2. lateral, 3. posterior and 4. anterior LV walls and for the 5. right ventricular (RV) lateral wall. SR/epsilon values describing radial deformation were higher than the corresponding SR/epsilon values obtained for longitudinal deformation. Longitudinal SR/epsilon were homogeneous throughout the septum and all LV walls. This was in contrast to the normal base-apex velocity gradient. The RV segmental SR/epsilon values were higher than those obtained from the corresponding LV wall and inhomogeneous (higher in the apical segments). SR/epsilon imaging appears to be a robust technique for quantifying regional myocardial deformation.

Adult↗
PubMed2001

Prevalence of Helicobacter pylori infection in coronary artery disease and effect of its eradication on coronary lumen reduction after percutaneous coronary angioplasty.

BACKGROUND: Gastric infection caused by Helicobacter pylori has recently been associated with increased risk of coronary artery disease. AIM: To: 1) determine seroprevalence of Helicobacter pylori and its cytotoxin associated gene A in patients with/without coronary artery disease (group A), 2) assess influence of Helicobacter pylori eradication on coronary artery lumen reduction after percutaneous coronary angioplasty (group B) and 3) determine influence of Helicobacter pylori eradication on plasma cytokines, lipids and coagulation factors in patients subjected to percutaneous coronary angioplasty (group B). PATIENTS AND METHODS: Group A included 100 patients with coronary artery disease (subgroup 1) and 100 patients without (subgroup II). For Helicobacter pylori seroprevalence, plasma anti-Helicobacter pylori and anti-cytotoxin associated gene A IgG were examined. Group B included 40 patients with significant single-vessel coronary arterial disease and Helicobacter pylori infection confirmed by 13C-urea breath test and serologically using anti-Helicobacter pylori and anti-cytotoxin associated gene A IgG. Six months after percutaneous coronary angioplasty and triple anti-Helicobacter pylori therapy, the Helicobacter pylori status reassessed by urea breath test was negative in all but two patients of subgroup I subjected to Helicobacter pylori therapy. Coronary angiography and laboratory tests were repeated in both subgroups of group B included in the trial and reduction in coronary artery lumen in these subgroups was compared to baseline after percutaneous coronary angioplasty considered as 100%. RESULTS: Helicobacter pylori seropositivity reached 81.5% of coronary artery disease (subgroup I) and was significantly higher than that in controls without coronary artery disease (subgroup II) (51%), the odds ratio being 4.3 for Helicobacter pylori in coronary artery disease. Cytotoxin associated gene A IgG detection was also significantly higher (47.3%) in coronary artery disease than in controls (28%) giving the odds ratio about 2.3. Mean coronary artery lumen reduction in patients undergoing percutaneous coronary angioplasty + Helicobacter pylori eradication therapy (subgroup I) was significantly (p<0.05) smaller compared to percutaneous coronary angioplasty + placebo-treated subgroup II (22% vs 41%). CONCLUSIONS: 1) There is a significant link between coronary artery disease and infection with Helicobacter pylori, especially expressing CagA proteins, 2) Helicobacter pylori eradication significantly attenuates reduction in coronary artery lumen in coronary artery disease patients after percutaneous coronary angioplasty possibly by elimination of chronic inflammation and decline in proinflammatory cytokine release, and 3) Infection of Chlamydia pneumoniae in these percutaneous coronary angioplasty patients is not affected by eradication therapy.

Adult↗
PubMed2001

Clinical and echocardiographic assessment of a right-to-left shunt across an atrial septal defect secondary to tricuspid regurgitation.

OBJECTIVE: Cyanosis in conjunction with atrial septal defect does not necessarily indicate the Eisenmenger syndrome. Exceptionally, the right-to-left shunt may result from tricuspid regurgitant flow and its unusual direction. METHODS: We describe thirteen patients with atrial septal defect and accompanying tricuspid regurgitation. In all of them, the tricuspid regurgitant jet was oriented towards the interatrial septum. This was found on the basis of echocardiographic examination and subsequent frame-by-frame analysis of videotape. RESULTS: Of thirteen patients, cyanosis was observed in 7 (53%). Among those seven, three had moderate pulmonary hypertension (pulmonary artery systolic pressure (PASP) between 40 and 60 mm Hg). The remaining four patients with marked pulmonary hypertension (PASP > 60 mm Hg) underwent cardiac catheterization, which demonstrated low values of pulmonary artery resistance. Except for the one patient with a history of the cerebral embolic event, all were qualified for cardiac surgery. In the postoperative observation they were uneventful and showed clinical recovery and echocardiographic improvement. CONCLUSIONS: Appreciable arterial desaturation and cyanosis in patients with ASD, regarded as uncomplicated, should be followed by careful investigation for the direction of tricuspid regurgitant flow.

Adult↗
PubMed2001

Helicobacter pylori (H. pylori) infection in coronary artery disease: influence of H. pylori eradication on coronary artery lumen after percutaneous transluminal coronary angioplasty. The detection of H. pylori specific DNA in human coronary atherosclerotic plaque.

BACKGROUND: The role of infections in pathogenesis of atherosclerosis has been a point of extensive discussion and research. Chronic infection has been proposed to account for the formation and progression of atherosclerotic plaques. Gastric mucosal damage caused by Helicobacter pylori (H. pylori) involves various bacterial and host-dependent toxic substances that have been recently associated with increased risk of coronary artery disease (CAD). AIMS: This study was designed to: 1) to determine the seroprevalence of H. pylori and its cytotoxin associated gene A (CagA) in patients with and without CAD (group A), 2) to evaluate the influence of infection with H. pylori expressing CagA (Cytotoxin associated gene A--as a determinant of high virulence) on coronary arterial lumen reduction in patients after percutaneous transluminal coronary angioplasty (PTCA) with stent (group B), 3) to assess the effect of H. pylori eradication on coronary artery lumen reduction after PTCA (group C), 4) to determine the influence of the H. pylori eradication on plasma levels of cytokines, lipids and coagulation factors in the same patients before and after PTCA (group C) and 5) to analyse coronary specimens in patients with severe CAD for the presence of H. pylori originated specific DNA (Group D). PATIENTS AND METHODS: Group A included 96 patients with CAD (subgroup I) and 96 patients without CAD (subgroup II). For H. pylori seroprevalence, plasma anti-H. pylori and anti-CagA IgG were examined by ELISA and Western blot. Group B included 135 patients (86 male, 49 female, mean age 67 +/- 12 years) who had underwent PTCA with stent implantation initially and recoronaro-angiography about 6 months afterwards. All patients were tested for H. pylori--specific antibodies (IgG and CagA). Patients were divided into three subgroup "a": 34 patients with H. pylori IgG and CagA seropositivity, subgroup "b": 37 patients infected with H. pylori positive and CagA negative germs and subgroup "c": 64 patients with H. pylori IgG sero-negativity serving as control group. For all patients coronary lumen loss (percentage) in the dilated segment was measured at the end of PTCA and during re-coronaro-angiography and obtained values were considered taking into account the major risk factors of CAD (hypertension, hyperlipidemia, diabetes, obesity and smoking). Group C included 40 patients with significant single-vessel CAD and H. pylori infection confirmed by 13C-urea breath test (UBT) and serologically using anti-H. pylori and anti-CagA IgG. In addition, plasma interleukin (IL)-1beta and IL-8 and tumor necrosis factor alpha (TNFalpha) levels were measured by ELISA. Plasma total triglycerides, cholesterol, low (LDL) and high density lipoproteins (HDL), homocysteine levels, as well as some clotting factors such as thromboplastin and fibrinogen levels, thrombin time and platelet count were determined. All patients of group B undergoing PTCA were divided into two matched subgroups I and II used in exploratory study; subgroup I (20 patients) received H. pylori eradication triple-therapy for one week (Clarithromycin, Amoxicillin and Omeprazole), while subgroup II (20 patients) received similarly prepared placebo for the same time period starting immediately after PTCA. Six months after PTCA, the H. pylori status was re-assessed by UBT and found to be negative in all but two patients of subgroup I subjected to H. pylori therapy. Coronary angiography and laboratory tests were repeated in both subgroups of group B included into the trial and the reduction in coronary artery lumen in these subgroups was compared to baseline after PTCA considered as 100%. Large atherosclerotic plaques from coronary endatherectomy were obtained in 46 consecutive patients (9 female, 37 male, mean age 63 +/- 9 years) during coronary bypass procedures (group D). Serum was analysed for positive IgG antibodies specific for H. pylori by enzyme-linked-immunosorbent assay (ELISA). Antibodies specific for the CagA were detected by immunoblot analysis. Polymerase chain reaction (PCR) was used to identify bacterial DNA with primers encoding for the 16 S ribosomal RNA of H. pylori. Sequence analysis of PCR-products confirmed the specificity of the gene products for H. pylori. Coronary artery biopsies from 19 autopsies from a Forensic Medicine Department without coronary atherosclerosis were examined as a control group. RESULTS: The H. pylori seropositivity reached 69.79% (67 pts) of CAD (subgroup I of group A) and it was significantly higher than that in controls without CAD (subgroup II)--40.62% (39 pts), the odds ratio (OR) being 3.38 95% CI: 1.8598-6.1306 for H. pylori in CAD. CagA IgG detection was also significantly higher (58.20%) in CAD group than in controls (35.89%) giving the OR about 2.49 (95% CI: 1.1012-5.6175). Mean lumen loss in group B in H. pylori-positive subjects was 37.0% +/- 17.3%, whereas for H. pylori negative patients 29.9 +/- 13.8% were measured compared to initial values following PTCA (p = 0.0196). Even subgroup analysis and analysis regarding risk factors show significantly higher lumen loss for H. pylori-positive patients (especially CagA positive) compared to H. pylori negative patients. Mean coronary artery lumen reduction in patients undergoing PTCA + H. pylori eradication therapy (subgroup I of group C) was found to be significantly (P < 0.05) smaller compared to PTCA + placebo-treated subgroup II (22% vs 41%). The plasma cytokines such as TNFalpha, IL-1beta and IL-8 were significantly lower after the H. pylori-eradication in PTCA patients, while changes in plasma lipids, homocysteine and clotting factors were not significantly affected by H. pylori eradication. In group D thirty two patients (69.5%) were H. pylori-seropositive, 14 patients out of 32 H. pylori-positive were CagA positive. Eighteen of these patients showed positive results for H. pylori DNA, whereas 4 patients of the seronegative group also showed positive DNA results, but all 4 had undergone eradication therapy within the past two years. A total of 22 patients (47.8%) of the CAD group and none of the 19 controls revealed positive DNA assessed by PCR. Out of 14 anti-Cag A positive patients 11 showed positive detection of H. pylori DNA (p = 0.015) CONCLUSIONS: 1) There is a significant link between CAD and infection with H. pylori, especially expressing CagA proteins; 2) Patients infected with CagA-positive H. pylori show significantly greater coronary artery lumen loss and arterial re-stenosis after PTCA with stent implantation; 3) H. pylori eradication significantly attenuates the reduction in coronary artery lumen in CAD patients after PTCA possibly due to the elimination of chronic inflammation and the decline in proinflammatory cytokine release and 4) The identification of DNA in atherosclerotic plaques of patients with severe CAD supports the hypothesis that infection with H. pylori (especially CagA positive) may influence the development of atherosclerosis.

Aged↗
PubMed1999

[Tuberculosis manifestations in the musculoskeletal system exemplified by Poncet's disease].

Tuberculosis is a communicable disease that is occasionally complicated by arthritis, either as part of a disseminated primary infection or through late reactivation, often in immunocompromised hosts such as elderly people, HIV-positive patients or patients under immunosuppressive therapy. Even though musculoskeletal manifestations occur in only about 2% of tuberculosis cases, they can be very heterogeneous and present as spondylitis, osteomyelitis or mono-oligo-polyarthritis. Because of the potential for disastrous outcomes in cases where the diagnosis is delayed, it is important to recognize the multiple rheumatological manifestations of tuberculosis. This case report on a patient with Poncet's disease discusses a current hypothesis regarding pathogenesis of reactive arthritis based on rheumatological manifestations of tuberculosis. The genomic detection of Mycobacterium tuberculosis, to differentiate between infectious arthritis and reactive arthritis by polymerase chain reaction, is of particular importance.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Hemodynamic indications for DDD mode pacing therapy].

BACKGROUND AND OBJECTIVE: Because there are limits to the drug treatment or surgical intervention of advanced heart failure, alternative methods are being explored. It was the aim of this study to investigate the extent to which optimal atrioventricular (AV) sequence of dual pacemaker stimulation in patients with advanced dilated cardiomyopathy (DCM) of different aetiology increases their usually much reduced cardiac output. PATIENTS AND METHODS: The study group consisted of 22 patients (five women, 17 men; aged 54-84 years) with heart failure in class I-IV (New York Heart Association classification). Temporary dual electrode stimulations (in the right atrium and ventricle) in the VDD or DDD mode were performed with programmed AV intervals between 80 and 180 ms. Cardiac output (CO), pulmonary capillary and pulmonary arterial pressures were measured via an indwelling catheter. RESULTS: In 17 patients with a 1 degree AV block and/or left bundle branch block in the surface ECG pacing produced a significant increase in CO (from 3.7 +/- 0.75 to 4.6 +/- 0.65 l/min; P < 0.005) and cardiac index (from 2.05 +/- 0.43 to 2.47 +/- 0.37 l/min/m2; P < 0.005). There was no increase in patients with normal PR interval and QRS duration. Mean pulmonary capillary and pulmonary arterial pressures remained unchanged. CONCLUSION: Alteration of AV sequence by pacemaker in selected patients in the late stage of heart failure, particularly if there is also abnormal atrioventricular and/or intraventricular conduction delay, may be an effective complementary method of treatment.

Aged↗
PubMed1998

Ischemic neurologic event in a child as a result of ventricular septal aneurysm.

Aneurysm of the interventricular septum without a shunt was found by means of transthoracic echocardiography in a 6-year-old boy with acute hemiparesis. Until the time of the incident, he had been healthy. The aneurysmal sac contained 2 clots, presumably resulting in the ischemic cerebral infarct. On the basis of the echocardiographic scan, successful surgery was performed. To the best of our knowledge, this is the first report describing such dramatic sequelae of interventricular septal aneurysm.

Brain Ischemia↗
PubMed1997

Fixation of carbon fibre-reinforced carbon composite implanted into bone.

The push-out test of three types of biomaterials: carbon fibre-reinforced carbon (CFRC), hydroxyapatite (HA), and surgical steel (SS) implanted into rabbits' femurs was carried out. Hydroxyapatite was used as a positive control (good fixation expected in bone) and surgical steel was a negative one (potentially no fixation in bone). Regeneration of bone in contact with all implants was found three months after implantation. The shear strength between CFRC implants and bone was lower than with the HA implants and higher than the shear strength between the surgical steel and bone. Compressive strength of CFRC implants removed after the observation period was significantly lower than the compressive strength of non-implanted samples. It is concluded that the mechanical bonding between the CFRC implants and host tissues exists 3 months after intrabone implantation and is accompanied by a decrease of the strength of implants.

Journal Article↗
PubMed1997

[Extracapsular cataract extraction with intraocular lens implantation after glaucoma surgery].

PURPOSE: To analyse results of cataract surgery with intraocular lens implantation in eyes with previous glaucoma surgery. MATERIAL AND METHODS: In the years 1994-1996 in 44 eyes of 39 patients (13 males and 26 females) cataract surgery was performed. The follow-up ranged from 3 to 12 months (mean 8.5 months). The time interval between glaucoma surgery and cataract surgery ranged from 1 month to 40 years. The most frequent kind of glaucoma surgery was trabeculectomy (77.3%). An inverse corneal incision and envelope capsulotomy was performed in every eye, thirty eight percent required synechiolysis and twenty percent iridoplastic surgery. RESULTS: Intraoperatively there were 2 cases of posterior capsule tears with vitreous loss and 4 mild hemorrhages into anterior chamber. The most common postoperative complications were Descemet's membrane folds (36.4%), fibrinous exudate in anterior chamber (27.3%) and transient corneal oedema (9.2%). Fifty percent of eyes achieved the best corrected visual acuity-5/8 and better. Postoperative astigmatism mostly with the rule was observed in 86.4% eyes. Postoperative intraocular pressure was unchanged in 81.8% eyes, and in 13.8 percent of eyes preoperative glaucoma medication was no longer required. CONCLUSIONS: The technique of extracapsular cataract extraction with intraocular lens implantation is a safe procedure giving good visual rehabilitation and having no influence on glaucoma control in patients who had previous glaucoma surgery.

Aged↗
PubMed1997

[Silicone oil tamponade in the treatment of retinal detachment with proliferative vitreoretinopathy].

AIM: This paper presents early and later stage of the treatment of 93 eyes (89 patients) with retinal detachment in the course of PVR. All patients were treated in our department between February 1992 and February 1994. METHOD: Standard port pars plana vitrectomy was performed in all cases related earlier with sclear buckling procedure without success. RESULTS: One week, 6, 12, 24 months after surgery good anatomical results were achieved respectively in: 82%, 80%, 78%. One week, 6, 12, 24 months after surgery good functional results were achieved respectively in: 74%, 67%, 58%. CONCLUSIONS: Vitrectomy with silicone oil tamponade is method of choice in the treatment of retinal detachment in the course of PVR.

Adult↗