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Biomedical subjects

P Jaszczak

Publications and source records attributed to P Jaszczak.

At least 19 recordsLinked to original sources
PubMed2001

Computer identification of neoplastic urothelial nuclei from the bladder.

OBJECTIVE: To introduce computer-based analysis of Feulgen-stained urinary bladder cell nuclei from voided urine to identify neoplastic urothelial nuclei. STUDY DESIGN: Nuclei from 23 healthy people and 33 patients with urinary bladder cancer were analyzed. The nuclei from 9 cancer patients with grade G1 (stage Ta), 17 with grade G2 (stages Ta, T1, T1a and T2) and 7 with grade G3 (stages Cis, Ta + Tis, T1 and T3b) were analyzed. Image analysis was carried out by means of a digital image processing system designed by the authors. Features describing nuclei were selected as the first step of the procedure. Then a multistage classifier was constructed to identify positive and negative cases. RESULTS: The results of this pilot study of a group of 56 patients yielded a 71% correct classification rate in the control group, while a 66% rate was obtained among the cancer patients. The sensitivity of the method was 100% and the specificity was 77%. CONCLUSION: This approach to the identification of neoplastic urothelial nuclei may be sufficiently well developed to be used successfully both in screening high-risk populations and in clinical practice.

Cell Nucleus↗
PubMed2000

A double-blind, randomized, comparative study evaluating clinical effects of two sequential estradiol-progestogen combinations containing either desogestrel or medroxyprogesterone acetate in climacteric women.

OBJECTIVES: The aim of this study was to compare a new sequential estradiol-desogestrel (E2-DSG) hormone replacement regimen (Liseta) with one of the standard treatments i.e. estradiol valerate-medroxyprogesterone acetate (E2V-MPA) combination (Klimalet) regarding the alleviation of climacteric symptoms, vaginal bleeding pattern and the occurrence of adverse experiences. METHODS: In a multicenter study performed in Denmark, a total of 376 perimenopausal women with climacteric symptoms were randomly allocated to oral sequential treatment with either E2-DSG (1.5 mg E2 for 24 days with 0.15 mg DSG for the last 12 days followed by a placebo tablet for 4 days) (n = 186) or with E2V-MPA (2 mg E2V for 21 days with 10 mg MPA for the last 10 days) (n = 190). Treatments were administered, using a double-blind, double-dummy technique for 6 cycles of 28 days. RESULTS: Three hundred and seventeen women, 158 in the E2-DSG and 159 in the E2V-MPA group, completed six treatment cycles. Both treatments reduced menopausal symptoms rapidly and to a similar extent. Hot flushes were present in 88% of the women in both groups. After six treatment cycles, hot flushes were no longer present in 71 and 62% of the women in the E2-DSG and E2V-MPA group, respectively. Perspiration decreased from 80 to 65% in the E2-DSG group and from 82 to 63% in the E2V-MPA group. Mood disturbances were present in 82% of the women in the E2-DSG at baseline, and in 52% after six cycles. In the E2V-MPA group the corresponding figures were 68 and 42%, respectively. The bleeding pattern was comparable in both treatment groups. Regular withdrawal (expected) bleeding appeared in 90-92% and in 85-90% of the women in cycles 1-5 with E2-DSG and E2V-MPA, respectively. Irregular bleeding (including spotting) occurred in 15.2% of the women receiving E2-DSG and in 20.1% of the women treated with E2V-MPA in cycle 6. In both treatment groups there was a tendency of a slight decrease in blood pressure. Adverse events were in less than 10% in each group the reason to discontinue treatment. CONCLUSIONS: Both treatments effectively alleviated menopausal complaints and presented good cycle control. Bleeding pattern and mood disturbances appeared to be more favorable influenced by E2-DSG.

Administration, Oral↗
PubMed1994

Atrial natriuretic peptide, blood volume, aldosterone, and sodium excretion during twin pregnancy.

BACKGROUND: The reports on plasma concentrations and physiological function of atrial natriuretic peptide (ANP) during pregnancy are conflicting. In a recent prospective study, including 40 healthy primigravidae, we found a highly significant decrease in the plasma concentration of ANP (p-ANP) during the third trimester and the results indicated that ANP takes part in regulation of blood volume and renal function during pregnancy as in the nonpregnant state. In order to test these results, a study was performed in primigravidae with twin pregnancy to test if the accentuated physiological changes here were followed by a corresponding greater decrease in p-ANP. METHODS: Ten healthy primigravidae with twin pregnancy were examined four times during pregnancy plus 12 weeks after delivery. Each time the following were measured: p-ANP, aldosterone, renin, blood volume (carbon monoxide), cardiac output (Doppler), blood pressure and sodium excretion. Interdependence of the changes in ANP and in the other parameters was tested using Spearman's rank correlation test on the delta (delta)-values (the differences in measurements between investigations). The results were compared to the results obtained during singleton pregnancy using the Mann-Whitney rank sum test. RESULTS: All pregnant values of p-ANP during twin pregnancy were lower than 12 weeks after delivery, p < 0.01. In the 20th, 28th, and 32nd week p-ANP was lower in twin pregnancy than in singleton pregnancy, p < 0.05. There was a negative correlation between changes in p-ANP and changes in: a) blood volume, R = -0.8, p < 0.0001, b) aldosterone, R = -0.66, p < 0.0001, c) renin, R = -0.52, p < 0.01, d) cardiac output, R = -0.68, p < 0.0001. There was a positive correlation between changes in p-ANP and changes in: a) fractional excretion of sodium, R = 0.73, p < 0.0001, and b) total peripheral resistance, R = 0.61, p < 0.0001. CONCLUSION: The results suggest that the competitive relationship between ANP and the renin-aldosterone system in regulating sodium balance and fluid volume is preserved during pregnancy. The vasodilation during pregnancy is not mediated by ANP.

Aldosterone↗
PubMed1993

Management of prelabor rupture of membranes at term. A randomized study.

OBJECTIVE: To compare the rate of obstetric interventions, length of labor, and maternal morbidity in pregnancies with prelabor rupture of membranes at term after either early or late induction of labor in both primiparous and pluriparous women. DESIGN: Prospective, randomized study. SUBJECTS: 362 women with singleton pregnancies, cephalic presentations, gestational age of 36 completed weeks or more were allocated at random to induction with oxytocin either 6 hours after PROM (n = 62) (early) or 24 hours (n = 62) (late). Those eligible, but not participating in the study, totalled 238 women. MAIN OBSTETRIC MEASURES: Time of spontaneous labor in the late induction group, length of labor, obstetric intervention rate, maternal morbidity, and the degree of histologic chorioamnionitis. RESULTS: The length of labor was longer in the late induction group than in the early induction group in both primiparous and pluriparous (p < 0.05). There were no overall differences in the rate of obstetric interventions or maternal morbidity, but there were marked differences between primiparous and pluriparous women. Increasing time span between the period from rupture of membranes to delivery increased the degree of histologic chorioamnionitis. CONCLUSION: If a woman wants a short labor, she will benefit from early induction. We did not find statistical differences in the rate of obstetric intervention or in the maternal morbidity, but there was a tendency towards adverse effects of late induction.

Adult↗
PubMed1993

Atrial natriuretic peptide (ANP) decrease during normal pregnancy as related to hemodynamic changes and volume regulation.

BACKGROUND: Volume regulation and hemodynamic functions change during pregnancy, leading to marked increases in blood volume and cardiac output, peripheral vasodilatation and reduced sensitivity to angiotensin. Atrial natriuretic peptide (ANP) is intimately involved in fluid and sodium homeostasis and exerts marked relaxant activity on vascular smooth muscle pre-contracted with angiotensin. This study was performed to clarify the role of ANP as a regulator of maternal physiology. METHODS: 40 normal primigravidae were examined five times during pregnancy plus 12 weeks after delivery. Each time were measured: ANP, aldosterone, renin, blood volume (carbon monoxide), cardiac output (Doppler), blood pressure and sodium excretion. Interdependence of the changes in ANP and in the other parameters was tested using Spearman's rank correlation test on the delta (delta)-values (the differences between investigations). RESULTS: P-ANP in the 20th week was 11.4 (8.5-18.9) pmol.l-1 (median, 25 and 75 percentiles), the same as 12 weeks after delivery, 11.5 (9.6-15.2) pmol.l-1, and in a non-pregnant control group, 10.4 (9.0-12.5) pmol.l-1 (n = 20). All measurements of P-ANP during the 3rd trimester were lower than in the 20th week and 12 weeks after delivery, p < 0.0001 (Wilcoxon matched-pairs test). There was a negative correlation between changes in P-ANP and changes in: a) blood volume. R = 0.69, p < 0.0001, b) aldosterone, R = 0.58, p < 0.0001, c) renin, R = -0.54, p < 0.001, d) cardiac output, R = 0.61, p < 0.001. There was a positive correlation between changes in P-ANP and changes in: a) fractional excretion of sodium, R = 0.54, p < 0.0001, and b) total peripheral resistance. R = 0.52, p < 0.0001. CONCLUSION: Decrease in p-ANP is one of the mechanisms whereby blood volume is increased and maintained during pregnancy. The competitive relationship between ANP and the renin aldosterone system in regulating sodium balance and fluid volume is preserved during pregnancy. The results substantiate the physiological importance of ANP as a regulator of blood volume. ANP does not function as a vasodilator during pregnancy.

Adolescent↗
PubMed1991

Skin oxygen tension, skin oxygen consumption, and skin blood flow measured by a tc-pO2 electrode.

By use of a combined tc-pO2 skin blood flow sensor E5250 and measurement of cutaneous and subcutaneous blood flows with the 133Xenon washout method it was demonstrated that blood flow in both tissues increases with a factor of 3-4 when the electrode temperature increases from 37 to 45 degrees C. In order to examine the influence of the gas diffusion barrier within the epidermal membrane the stratum corneum of the forearm was removed selectively by stripping with adhesive tape. Stripping increased the oxygen tension values from 10.98 +/- 0.63 kPa to 14.58 +/- 1.03 kPa, and skin oxygen consumption ranged from 0.208 to 0.251 ml O2.(100g.min)-1. The combination of a Clark type electrode with a heat sensor allows determination of oxygen delivery to the skin as well as the oxygen supplying cutaneous blood flow. The distribution of blood flow between nutritional and shunt vessels at various local temperatures remains to be clarified.

Blood Flow Velocity↗
PubMed1989

[Cesarean section under epidural anesthesia. A questionnaire study].

Seventy-four women selected at random who had been subjected to Caesarean section replied to questions about their satisfaction with epidural anaesthesia at various stages during the intervention. General discomfort increased during the intervention and pain contributed most to this. 96% of the women would recommend the method to others.

Adult↗
PubMed1988

Blood flow rate, temperature, oxygen tension and consumption in the skin of adults measured by a heated microcathode oxygen electrode.

Reliable transcutaneous measurements of arterial oxygen tension are based on a maximum skin blood flow rate which is created by heating the skin, typically at an electrode temperature of 44 to 45 degrees C. This increase in skin blood flow rate creates an arterialization of the oxygen tension in the capillaries and the surrounding tissue. The heat conducted to the skin surface is removed by a combination of convection (skin perfusion) and conduction to the deeper layers of the skin. This heat transport to and through the skin surface causes a measurable temperature profile from the electrode surface to the capillary layer. By a blood flow cessation it is possible to change the temperature profile because the convective part of the heat consumption is eliminated and the conductive part can then be measured and subtracted. Using the forearm as measuring area and a heated tc-PO2 electrode several observations were made. The mean temperature gradient over epidermis down to the capillary layer at an electrode temperature of 43, 44, and 45 degrees C was 2.1, 2.4 and 2.7 degrees C, respectively. The change in temperature profile caused by the blood flow cessation enabled primarily an estimation of the skin blood flow rate by temperature measurements, ranging from 0.07 to 0.24 ml.cm-2.min-1. Increasing blood flow rates correlated to increasing tc-PO2 values. By means of a dynamically, thermally shielded tc-PO2 electrode it was possible to determine the skin blood flow rates in the same arbitrary units computed on the basis of the heat dissipation to the skin surface. Furthermore, it was possible to correlate these blood flow estimations to the cutaneous blood flow rates measured by 133Xe washout technique. By increasing the electrode temperature the cutaneous blood flow rates increased from 12 to 50 ml.(100 g)-1.min-1. It was possible to calculate a conversion factor on the basis of the correlation between the heat determinations of the skin blood flow rate and the 133Xe measurements. Using this conversion factor the highest blood flow rate did not exceed 55 ml.(100 g)-1.min-1. The subcutaneous blood flow rate increased accordingly with increasing electrode temperature. It was concluded that the measured heat consumption of the skin is effected by the heat removing capacity of the cutaneous as well as the subcutaneous blood flow. The cutaneous blood flow, however, was considered predominant in the transport of heat from the skin surface. By 50 times of stripping the skin surface, the cornified epidermal membrane was removed. This procedure increased the tc-PO2 values by on an average 3.6 kPa (27.1 mmHg).(ABSTRACT TRUNCATED AT 400 WORDS)

Blood Gas Monitoring, Transcutaneous↗
PubMed1987

Oxygen tension and consumption measured by a tc-PO2 electrode on heated skin before and after epidermal stripping.

Oxygen tensions, cutaneous blood flow rate, and skin oxygen consumption rate were determined by tc-PO2 measurements at an electrode temperature of 45 degrees C. The epidermal surface was stripped by 50 applications of adhesive plaster to the surface. Ten healthy, normotensive adults were examined. Cutaneous blood flow rate was 41.2 +/- 8.6 ml X (100 g)-1 X min-1 before and 42.8 +/- 5.9 ml X (100 g)-1 X min-1 after epidermal stripping. Oxygen consumption before stripping was 0.327 +/- 0.065 ml O2 X (100 g)-1 X min-1, and after stripping it was determined at two different saturation levels to be 0.208 +/- 0.072 ml O2 X (100 g)-1 X min-1 and 0.251 +/- 0.096 ml O2 X (100 g)-1 X min-1. Capillary temperature was estimated to be approximately 43 degrees C before and after stripping. At this temperature mean arterial PO2 was estimated to be 18.1 kPa (136 mmHg), which would be reduced by the computed local metabolism to a mean capillary PO2 of 14.4 kPa (108 mmHg) before stripping and 15.2 kPa (114 mmHg) after. Stripping increased mean skin PO2 from 10.9 +/- 0.6 kPa (82.3 +/- 4.7 mmHg) to 14.6 +/- 1.0 kPa (109.4 +/- 7.7 mmHg). Thus, stripping eliminated 82% of the gradient between the capillaries and electrode while reducing the computed oxygen consumption by 23-36%. It is concluded that the epidermal membrane is a significant barrier to oxygen diffusion and that the transcutaneous oxygen electrode has a significant effect on skin PO2 owing to its own even low oxygen consumption. This will reduce the observed skin PO2 significantly.

Adult↗
PubMed1987

Direct vision internal urethrotomy. A prospective study of 81 primary strictures treated with a single urethrotomy.

The post-operative treatment of urethral strictures as well as the criteria of success have varied considerably. In order to find a solution to this problem, we undertook a prospective evaluation of 81 men treated for their first urethral stricture with a single urethrotomy. Fifty-one patients with a stricture 5 mm or less in length were catheterised post-operatively for 3 days. Patients with strictures longer than 5 mm were catheterised for 3 weeks (14 patients) or 6 weeks (16 patients). All were followed up for a minimum of 24 months. The stricture recurred in 33 patients (41%). We found that 3 days' catheter drainage was sufficient for patients with short strictures. Whether strictures measuring more than 5 mm might be treated similarly needs further investigation.

Adolescent↗
PubMed1985

A combined tc-PO2 and skin blood flow sensor.

A new approach to the determination of energy delivered to the skin during transcutaneous oxygen tension (tc-PO2) measurements was tested. The test was carried out using a tc-PO2 electrode constructed with an active thermal shield in order to provide more sensitive and specific heat transport measurements, and consequently to create the possibility of determining skin blood flow rates. The oxygen measurement properties did not differ from the conventional tc-PO2 electrode. In vivo measurements were performed on 11 adult volunteers. Skin blood flow was determined by a blood flow cessation technique to be 0.124 +/- 0.053 ml . cm-2 . min-1 at the start of the experiments, rising to 0.164 +/- 0.61 ml . cm-2 . min-1. Tc-PO2 changed from 56.2 +/- 9.8 mmHg (7.5 +/- 1.3 kPa) to 68.3 +/- 9.0 mmHg(9.1 +/- 1.2 kPa). It is concluded that a thermally shielded electrode makes it possible to determine the convectional component of the heat loss from the electrode to the skin and consequently to compute a relative measure of skin blood flow rate. The observed change in computed skin blood flow rate was correlated to the observed change in tc-PO2 (P less than 0.1).

Body Temperature Regulation↗
PubMed1984

Determination of skin blood flow by 133Xe washout and by heat flux from a heated tc-PO2 electrode.

133Xe washout measurements were used to determine cutaneous and subcutaneous blood flow beneath a specially designed double-thermostat tc-PO2 electrode. The skin blood flow was determined using thermal methods based on reduced heat dissipation during blood flow cessation. A total of 20 measurements were performed on two healthy volunteers, using the volar side of the right forearm as the experimental area. Cutaneous as well as subcutaneous blood flow increased with increasing electrode temperature. The cutaneous blood flow increased from 12.3 +/- 1.3 ml (100 g)-1 X min-1 (37 degrees C) to 49.1 +/- 5.4 ml (100 g)-1 X min-1 (45 degrees C) and the subcutaneous values from 20.9 +/- 0.2 ml (100 g)-1 X min-1 to 57.3 +/- 0.5 ml (100 g)-1 X min-1. Preheating of the measuring area or injection of papaverine as blood flow accelerator did not increase the maximum blood flow values. A considerable inter-individual difference between cutaneous and subcutaneous blood flow was observed, but in spite of that a good overall correlation between the 133Xe washout measurements and the two thermal flow measurements was found (r = 0.932 and 0.945, respectively). It is concluded that in some cases, but not always, measurements of tc-PO2 at electrode temperatures of 45 degrees C take place on a maximally perfused skin and that it is possible to determine skin blood flow by means of determinations of the heat dissipated from the tc-PO2 electrode to the underlying skin.

Adult↗
PubMed1983

Estimation of blood flow in transcutaneous PO2 measurements.

A method for estimation of the cutaneous blood flow in transcutaneous PO2 measurements is presented. Recordings of electrode and skin temperature make it possible to compute the effect dissipated to the circulating blood. Eighteen measurements were performed on three healthy volunteers at electrode temperature settings from 37.0 degrees C to 45.0 degrees C. The blood-flow estimates ranged from 0.07 to 0.19 ml . cm-2 . min-1. At an electrode temperature of 45.0 degrees C the investigations showed a tc-PO2 value as low as 7 mmHg (0.9 kPa) which, however, corresponded well to the lowest blood-flow estimate determined. The temperature-corrected (37 degrees C) a-PO2-tc-PO2 gradient ranged from 50 mmHg to 95 mmHg (6.7-12.6 kPa). The investigations confirm the importance of simultaneous determinations of cutaneous blood flow, capillary temperature and cutaneous oxygen consumption in order to describe the connection between arterial and cutaneous oxygen tension. The cutaneous blood flow seems in this connection to be the most important parameter.

Electrodes↗
PubMed1983

A follow-up study of the Marshall-Marchetti-Krantz vesicourethral operation for female incontinence.

A Follow-up study on 65 consecutive patients who underwent vesicourethral suspension (Marshall-Marchetti-Krantz' operation) in the period 1961-70 was carried out. Indications and results were evaluated. Forty-one patients completed the investigation. Twenty-five patients were operated on correct indication (pure stress incontinence). Twenty patients (80%) were cured and the vaginal examination were in accordance to this result.--Unfortunately several side-effects to this operation were observed (primarily infravesical obstruction, urge phenomenon and dyspareunia). Therefore posterior suspension of the bladder is recommendable. Carefully history, cystometry and colpo-cystourethrography seems necessary in the evaluation of female incontinence.

Adult↗