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Biomedical subjects

R Jankowski

Publications and source records attributed to R Jankowski.

At least 55 records · Page 3Linked to original sources

[Injuries of the spinal cord and vertebral column in children and adolescents].

A review of 127 pediatric patients admitted to the Department of Neurosurgery between 1965 and 1993 because of spinal cord and vertebral column injuries is presented. The aim of this paper is to relate clinical appearance and age of the patient. Patients were subdivided into two age groups on the grounds of skeletal development features. The first included 22 patients (3-14 years of age), the second one included 105 patients (15-18 years of age). Accident type, injury mechanism, level of the spinal injury and type of treatment differed in these groups as was found clinically and statistically. Younger group was mostly treated conservatively and the results of treatment were better.

Adolescent↗

[Clinical analysis of 126 patients with spinal metastases].

A series of 126 patients with spinal metastases and spinal cord lesion treated between 1963 and 1992 at Neurosurgery Department in Poznań has been presented. Neurological condition of the patient, neuroradiological and histological examinations are presented; modalities of management and results are discussed. Treatment was depended on the patient's conditions. Surgery was undertaken if spinal metastasis was the first symptom of the disease. Sixty-one per cent of patients died within 6 months after being diagnosed. Survival was longer in patients treated surgically. Fifty-six percent of them became ambulatory and in majority free of radicular pain. The longest survival was in prosthetic metastases, the shortest in pulmonary ones.

Adult↗

[Disorders of the cranio-spinal junction].

Seventy-three patients were treated due to cranio-cerebral junction disorders between 1980 and 1993. All patients were categorized into three groups depending on the disorder type: congenital (38%), traumatic (47%), or neoplastic (15%). In every group character of the lesion, neurological symptoms and indications for surgical or conservative management were analyzed. The outcome was following: neurological status was improved in 24 cases, in 30 cases the condition was stabilized, progressed in 18 cases and 1 patient died.

Adolescent↗

Onset and duration of inhibition of ipratropium bromide nasal spray on methacholine-induced nasal secretions.

We performed a randomized, double-blind, placebo-controlled cross-over study with two different concentrations of ipratropium bromide (Atrovent) nasal spray to evaluate its onset and duration of inhibition. Twenty-four subjects with perennial rhinitis participated in the trial. Fifteen minutes to 12 hours after administration of ipratropium bromide (42 or 168 micrograms/nostril) or placebo nasal spray, methacholine challenges were performed and nasal secretion weights measured. After placebo administration the effect of methacholine remained unchanged over the 12-h-period. Both the 42 and 168 micrograms/nostril doses significantly inhibited the nasal hypersecretions induced by methacholine challenge within 15 min of treatment (P < 0.05). The 168 micrograms dose of ipratropium bromide continued to significantly reduce secretion weights through 6 hours, but the effectiveness of the 42 micrograms dose disappeared within 3 h. In addition to having a longer duration, the 168 micrograms/nostril dose produced approximately twice the inhibitory effect of the 42 micrograms dose.

Adult↗

[Diagnostic significance of percutaneous needle biopsy in metastatic neoplasms of the spine].

A retrospective review of percutaneous needle biopsy due to the vertebral metastatic neoplasms performed in 92 patients treated from 1975 to 1992 at Department of Neurosurgery, K. Marcinkowski University of Medical Sciences. Thoracic biopsies constituted 45 per cent, lumbar-32 per cent, cervical-18 per cent and sacral ones 5 per cent of all procedures. An accurate diagnosis was made in 70 per cent of all cases. The highest accuracy rate was noted in lesions compromising the entire vertebral body (84 per cent) and posterior elements of the vertebrae (89 per cent). Tomographic X-rays, CT and MRI were helpful in visualization of concomitant paravertebral mass. In these cases accuracy rate of the biopsy was 82 per cent. The technique of percutaneous biopsy and histological results were also discussed.

Biopsy, Needle↗

[Occupational allergic rhinitis].

The frequency of occupational allergic rhinitis has grown with the development of new allergens and the prodromic characteristic of occupational asthma. The clinician must carefully assess the often unimpressive symptomatology with a characteristic work/non work cycle. The nasal mucosa is examined rhinoscopically to eliminate a possible tumoural origin. The diagnosis is based on the results of the allergy tests (skin tests, laboratory tests, nasal allergen tests) and on knowledge of the patient's work environment. The diagnosis of occupational rhinitis requires eliminating the allergen(s). A report of an occupational disease is required. In the future, informing atopic subjects early, improving working conditions and modifying industrial techniques should lead to a reduction in the prevalence of allergic rhinitis and occupational pulmonary disease.

Endoscopy↗

[Brain neoplasms in pregnancy. Two case histories].

The diagnosis of brain tumor in a pregnant women is a dramatic event. The nature and timing of therapy at intracranial neoplasm are affected by the existence of the pregnancy. The authors report a two cases of cerebral neoplasm in pregnancy. Clinical syndromes, diagnosis, neurosurgical and obstetrical management are discussed.

Adult↗

Effect of terfenadine on nasal provocation.

The effect of premedication with terfenadine, an H1 antagonist, on nasal challenge with antigen, histamine and methacholine was evaluated. A single dose of terfenadine had no effect on the response to a localized challenge with methacholine but completely blocked the secretory response to histamine on both the ipsilateral and contralateral sides. These results suggest that terfenadine has no anticholinergic activity and that the direct and reflex secretory response to challenge with histamine is mediated by the H1 receptor. A single dose of terfenadine significantly reduced sneezing and nasal secretion after challenge with antigen but had no effect on nasal congestion. A double-blind placebo-controlled clinical trial was undertaken to compare the effects of pretreatment with terfenadine for 1 week on the response to sequential nasal challenge with antigen and histamine. Terfenadine significantly reduced the number of sneezes and the levels of kinins, albumin and TAME esterase activity following challenge with antigen. The levels of histamine were also significantly reduced, suggesting inhibition of the degranulation of mast cells. The number of sneezes and the levels of albumin were also significantly reduced by terfenadine following challenge with histamine.

Humans↗

Reflex activation of nasal secretion by unilateral inhalation of cold dry air.

Exposure to cold dry air induces rhinorrhea and other nasal symptoms in many persons. To evaluate whether this response involves a neurogenic component, we delivered a unilateral cold dry air (UniCDA) nasal challenge to volunteers with previously documented reactivity to cold dry air. We measured their nasal secretory responses bilaterally using small filter paper discs to absorb secretions from the nasal mucosa. UniCDA increased nasal secretion both ipsilateral (p < 0.001) and contralateral (p < 0.001) to the challenge when compared with control challenge. Topical atropine (0.225 mg), a muscarinic antagonist, inhibited ipsilateral secretion (p < 0.002) when given ipsilateral to UniCDA. When atropine was given contralateral to UniCDA, there was a trend toward reduction of contralateral secretion but no effect on ipsilateral secretion. Topical anesthesia with lidocaine given ipsilateral to UniCDA inhibited ipsilateral (p < 0.02) and contralateral (p < 0.05) secretion immediately after challenge. Topical anesthesia did not inhibit methacholine-induced nasal secretion. Thus, UniCDA stimulates reflex secretion both ipsilateral and contralateral to challenge which is inhibitable by interrupting either the efferent or the afferent arm of the reflex arc. This human in vivo model supports the importance of neural mechanisms in airway responsiveness to an environmental stimulus.

Adult↗

[Injuries of the spine and spinal cord as isolated and multiple injuries].

A series of 511 patients after vertebral column and spinal trauma admitted to Department of Neurosurgery of University of Medical Sciences, Poznań from 1979 to 1992 has been analyzed. Isolated vertebral and spinal injuries in 49 per cent. In 51 per cent they were associated with multiple injuries. Traffic accidents constituted the main cause (50 per cent of multiple injuries). The severity of the injury was assessed on the base of AIS, ISS rating systems and spinal symptoms. The concomitant multiple injuries were no cause of delay to surgical intervention within vertebral column. The short-term results of the treatment were better in isolated spinal injuries, with 5 per cent mortality rate in both groups.

Accidents, Traffic↗

Demonstration of bilateral cholinergic secretory response after unilateral nasal cold, dry air challenge.

Cold, dry air (CDA) causes rhinorrhoea and nasal congestion in some individuals. This response can be mimicked in the laboratory by exposing susceptible individuals to cold, dry air nasal breathing. One of the characteristics of this response is that nasal secretions are produced by both nostrils after a unilateral challenge. This study evaluated the role of cholinergic innervation on the ipsi- and contralateral responses to unilateral CDA challenge. Twelve individuals participated in a randomized, double-blind, placebo-controlled, 3-way crossover study where local atropine and placebo were alternated ipsilateral and the contralateral to the CDA challenge. The reproducibility of the model, assessed by the response after pre-treating with placebo, was excellent; after placebo, the ipsilateral response was double the size of the contralateral. Regardless of the site of application, atropine significantly reduced the secretory response to CDA by 60-70%. However, significant secretions were still induced by CDA, even after atropine treatment. We conclude that cholinergically-mediated neuronal pathways play a major role in the nasal secretory response to CDA. Additional neuronal pathways may, however, be involved. This method is a tool to understand the different components of the mucosal response to a cold and dry environment.

Adult↗

Oesophageal carcinoma: the need for screening.

Oesophageal cancer is a substantial cause of mortality in the Western world and recent data indicate that the incidence is increasing. Despite better understanding of the pathogenesis and in the surgical management of the disease, little improvement in the survival rates has been achieved anywhere in the world, especially because screening for detection of premalignant lesions cannot, at present, be adequately applied to populations at risk. The present review summarizes current knowledge of the use of conventional screening methods as well as possible applications of new techniques to targeted populations to permit earlier diagnosis of premalignant lesions of the oesophagus.

Adenocarcinoma↗

Behçet's syndrome in Scotland.

We present the clinical details and HLA typing of 15 Celtic Caucasian patients (four male, 11 female) with Behçet's syndrome (International Study Group criteria). The males affected were younger than the affected females, and three of these males had severe uveal involvement. Two of the 15 patients had the A2 Bw6 Dr4 haplotype but this did not confer family penetrance. Eight had gastrointestinal involvement: two females required ileostomy, two females had chronic diarrhoea, one female had severe ileitis and oesophageal lesions, two males had peptic ulcers, and one female had a peptic ulcer and primary biliary cirrhosis. All of those who developed gastrointestinal symptoms had either the Dr4 or the Dr7 antigens. This study is the largest HLA survey of Celtic Caucasians with Behçet's syndrome. The clinical features and HLA haplotypes are markedly different from 'Arab' and 'Japanese' varieties of Behçet's syndrome. The expression of the Dr4 and Dr7 antigens in those with gastrointestinal involvement possibly implicates class II antigens (Dr) in the pathogenesis of the manifestations of Behçet's disease in the bowel.

Adult↗

[The management of subarachnoid hemorrhage in pregnancy].

Subarachnoid haemorrhage (SAH) from an intracranial aneurysm or arteriovenous malformation is a grave complication of pregnancy. Authors critically analyzed 12 cases of verified SAH during pregnancy from an 11 identified and 1 unidentified cerebral vascular malformation. Aneurysms were responsible for SAH in 7, and arteriovenous malformations in 4 patients. Subarachnoid haemorrhage occurred during I trimester in 2, II trimester in 3, III trimester in 6 patients and after cesarean delivery in 1 case. We conclude that the decision to operate after SAH during pregnancy should be based upon neurosurgical principles, whereas the cesarean delivery should be done in every pregnant patient with SAH.

Adult↗