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Biomedical subjects

T Trojanowski

Publications and source records attributed to T Trojanowski.

At least 37 records · Page 2Linked to original sources
PubMed1984

Early effects of experimental arterial subarachnoid haemorrhage on the cerebral circulation. Part I: Experimental subarachnoid haemorrhage in cat and its pathophysiological effects. Methods of regional cerebral blood flow measurement and evaluation of microcirculation.

Studies of pathophysiological changes, regional cerebral blood flow (rCBF) and cerebral microcirculation were performed in cats subjected to arterial subarachnoid haemorrhage (SAH). An original method for SAH imitating aneurysm rupture was developed. The bleeding was induced by puncturing of the internal carotid artery approached tranpresphenoidally and followed by immediate closure of the skull opening. It was found, that arterial subarachnoid bleeding elevates intracranial pressure and results in a transitory fall in cerebral perfusion pressure which is not prevented by elevation of arterial blood pressure (Cushing reflex). A depression in brain electrical activity and respiration rate were present in the course of subarachnoid haemorrhage.

Animals↗
PubMed1984

Early effects of experimental arterial subarachnoid haemorrhage on the cerebral circulation. Part II: Regional cerebral blood flow and cerebral microcirculation after experimental subarachnoid haemorrhage.

Employing the experimental set-up and the methods described - in part I of the paper, the measurements of the regional cerebral blood flow (rCBF) and evaluation of brain microcirculation were performed. The control series provided normal values and constituted the reference for the results of the post-haemorrhagic measurements. Arterial subarachnoid haemorrhage increases transitorily the intracranial pressure to values close to the diastolic blood pressure. The rise of the blood pressure (Cushing response) is not adequate to prevent the reduction in the cerebral perfusion pressure. Cerebral blood flow diminishes after arterial subarachnoid haemorrhage during the elevation of intracranial pressure. It results in numerous, disseminated areas of reduced regional cerebral blood flow. During 4 hours following arterial subarachnoid haemorrhage global cerebral blood flow returns to normal values, while focal reductions in blood flow persist in the grey matter structures of both hemispheres. These foci are accompanied by confined areas of markedly increased regional cerebral blood flow. Disseminated foci with a reduced number of patent capillaries are found in the grey matter structures of both hemispheres 1 and 4 hours following arterial subarachnoid haemorrhage. Their number decreases during the 4 hours observation.

Animals↗
PubMed1982

Blood-brain barrier changes after experimental subarachnoid haemorrhage.

Cerebral vascular permeability and blood-brain barrier in the acute stage of subarachnoid haemorrhage were studied in experiments on cats. The bleeding was induced by a special method, imitating the natural course os subarachnoid haemorrhage. Fluorescence of the Evans blue injected intravitally was used as an indicator. It was found that one hour after the subarachnoid haemorrhage there are discrete diffuse spots of translucency related to the individual vessels, appearing bilaterally in the cerebral cortex and to a lesser extent in the white substance. Four hours after the bleeding, the extravasations and tissue staining become more widespread and confluent. There are more areas with disturbed blood-brain barrier, and they are better differentiated from the normal tissue. They are distributed bilaterally throughout the brain with predominance on the side of the bleeding vessel. The possible mechanisms of the blood-brain barrier disturbance afer subarachnoid haemorrhage are discussed.

Animals↗
PubMed1982

Experimental subarachnoid haemorrhage. Part I. a new approach to subarachnoid blood injection in cats.

A method for experimental production of subarachnoid haemorrhage in a cat is described. Blood from the abdominal aorta is directed to the perichiasmatic cistern through a catheter. The cistern is punctured by passing a needle through the optic foramen. Arterial bleeding into a basal cistern of the subarachnoid space, under normal pressure for the animal, with an intact skull, closely fulfils requirements of experimental simulation of subarachnoid haemorrhage.

Animals↗
PubMed1982

Experimental subarachnoid haemorrhage. Part II: extravasation volume and dynamics of subarachnoid arterial bleeding in cats.

The volume and dynamics of arterial subarachnoid bleeding in a cat were studied. Using an arterial shunt, blood was directed into the chiasmatic cistern. The blood flow and pressure in the shunt, as well as intracranial pressure, were registered. It was found that the bleeding is a biphasic event, lasting about 118 seconds. During the initial high flow phase, lasting 1/3 of the time of the bleeding, 2/3 of the extravasated blood fills the subarachnoid space. The resulting rise of intracranial pressure reduces the flow markedly. The average volume of extravasated blood was found to be 2.4 ml. The haemorrhage was arrested 25-60 seconds after the maximum ICP elevation was reached.

Animals↗
PubMed1976

Dynamics of the blood pressure changes in sodium nitroprusside induced controlled arterial hypotension in neurosurgery.

Dynamics of the arterial blood pressure changes under the influence of intravenous infusion of sodium nitroprusside (SN) were studied in 12 patients operated on for intracranial aneurysms. Adequate measures were undertaken to avoid blood pressure (BP) changes due to the anaesthetic procedure itself. It was found that the speed of BP lowering corresponded to the rate of infusion, and could easily reach 10 mm Hg/min. After stopping the infusion, the BP recovery rate averaged a mean speed of 8.5 mm Hg/min, varying from 3.8 to 12 mm Hg/min. High speeds of BP lowering and recovery achieved with the use of SN are the main advantages of this hypotensive agent in neurosurgical procedures.

Adult↗
PubMedDate not supplied

[Metastatic tumors in vertebral canal].

Medical records of patients suffering from spinal cord or cauda equina compression secondary to metastatic tumour of the spinal canal were reviewed. Out of 55 patients treated in the Department of Neurosurgery in Lublin throughout 1976-1996 for metastatic disease of the spinal canal, forty were operated on. Clinical symptoms, methods of treatment and course of disease in this last group of patients were analysed. It showed that the great majority of patients are admitted to the neurosurgical department with severe neurological deficits. Eighty percent of patients (n = 40) presented with deterioration of gait and 67.5% had retention of urine, 72.5% had sphincter disturbances. The series comprised patients with carcinoma of the lung (22.5%), kidney (7.5%), prostate (7.5%), neoplastic disease of the lymphatic system (12.5%) and other malignant neoplasm accounting for 62.5%. As a general rule, decompressive laminectomy was carried out. Surgery was usually performed as an emergency in order to arrest progression of neurological deficits and to prevent irreversible damage to the roots and spinal cord. The tumours were usually extradural, located in the lower part of the thoracic spine and invading surrounding tissues, including bone. Histological diagnosis of spinal tumour as a metastasis preceded diagnosis of a primary tumour, but in 1/3 of cases histology could not indicate of the primary malignancy. There are substantial differences in the clinical course of a metastasis in the thoracic and lumbosacral spine. Own experience indicates that surgery of spinal metastases in patients with severe neurological deficits has a very limited effectiveness.

Adult↗
PubMedDate not supplied

[The influence of radiation doses on the results of radiosurgery of brain arteriovenous malformations].

Stereotactic radiosurgery as a method of treatment of inoperable brain angiomas has been in use in the Neurosurgery Department, Medical Academy in Lublin since 1990. The patients receive radiation from a Neptune 10P linear accelerator of 9 MeV photon energy (X radiation). The Laitinen stereoadapter used by us makes possible precise targeting and radiation application in time suitable for the patient and the whole treatment team. This frame produces no disturbances of CT image and is not covering the target. Non-invasive head immobilization in the frame is highly stable, although it requires good communication with the patient and his full cooperation. The purpose of the study was a comparison of the results of radiosurgery applied in the treatment of inoperable brain angiomas of various size with radiation doses 4000 cGy and 3000 cGy. The material comprises 40 first cases out of over 120 patients treated in this way for inoperable angiomas. The first group of 20 patients received 4000 cGy and the second group of 20 patients received 3000 cGy doses. Complete obliteration of angiomas was achieved in 16 (80%) cases treated with the 4000 cGy dose, and in 17 (85%) cases treated with the 3000 cGy dose. Late postradiation reactions developed in 15 (75%) patients in the first group with permanent changes in 5 (25%) patients. In the second group late postradiation reactions developed in only 6 (30%) cases and regressed in all. Treatment effectiveness (complete obliteration) after doses of 3000 and 4000 cGy was similar, and it decreased with greater size of angiomas. The per cent of postradiation complications after lower doses was much smaller, and permanent neurological changes were seen only after higher doses. The obtained results of the method are comparable with those of the authors using invasive methods of fixation of stereotactic frames.

Adolescent↗
PubMedDate not supplied

[Sodium nitroprusside in controlled arterial hypotension during neurosurgical operations].

A 0.02% solution of sodium nitroprusside was given in intravenous drip infusion for induction of controlled arterial hypotension during intracranial operations. The drug was given to 9 patients operated upon for aneurysms and 2 patients with intracranial meningiomas. It was observed that arterial blood pressure could be easily controlled in this way for the purposes of operation.

Adult↗
PubMedDate not supplied

Controlled arterial hypotension during neurosurgical operations.

Controlled arterial hypotension was applied in 62 hyperventilated patients during neurosurgical operations. Hypotension was obtained using trimetaphan (19 cases), trimetaphan and halothane (32 cases) and sodium nitroprusside (11 cases). It was found that the action of sodium nitroprusside was the quickest and lasted the shortest, which considerably facilitated the control of hypotension. Halothane permitted hypotension to be obtained rapidly but in certain cases it prolonged the hypotensive action of trimetaphan.

Adolescent↗
PubMedDate not supplied

[Value of isotope scintigraphy and angiography in the diagnosis of brain neoplasms].

The results of cerebral angiography and isotope scintigraphy were compared in 50 patients with brain tumours. The usefulness of each method for detection, localization and determination of the size of the tumour was evaluated. The overall detection rate of brain tumours was 92% in the case of angiography and 90% for scintigraphy, the possiblity of localization was 86% and 90% and size determination was 50% and 74% respectively. Scintigraphy often failed in the diagnosis of astrocytomas and tumours situated near the base of the brain, but this method was more reliable in evaluating the site and size of tumours than angiography.

Adolescent↗
PubMedDate not supplied

[Diagnosis of cerebello-pontine angle tumors].

History and results of investigations in 34 patients with cerebello-pontine angle tumours are presented. Tumour was diagnosed in the first, audiological stage of the disease only in 4 patients. In 7 more patients additional symptoms of central nervous system focal disorders occurred. The remaining 23 patients were in the third stage of the disease with symptoms of increased intracranial pressure. The main reason for such a late diagnosis of the tumour was neglecting of the early audiological symptoms of the disease by patients and by general practitioners as well.

Adult↗
PubMedDate not supplied

[Analysis of the results of combined treatment of poorly differentiated brain gliomas].

In a group of 139 patients with poorly differentiated brain gliomas controlled clinical trial was carried out for assessment of two methods of postoperative treatment. After possibly radical removal of the glioma the patients were treated by radiotherapy with 60Co teletherapy in doses of 60 Gy (30 fr) in depth during 6 weeks, and randomly chosen patients received also CCNU in one dose of 100 mg/m repeated at intervals of 6-8 weeks. The administration of CCNU failed to improve the therapeutic results. The median survival time in the whole group was 49 weeks. The survival rate after 1, 2 and 3 years was 45.4%, 22.8% and 14.9% respectively. The survival times of cases of glioblastoma multiforme were not significantly different from those of patients with other poorly differentiated gliomas independently of the treatment method. The complications were not troublesome.

Adolescent↗
PubMedDate not supplied

[Results of non-operative treatment of primary brain tumors using teleradiotherapy and chemotherapy].

In the years 1979-1984 25 patients with inoperable primary brain tumours were treated. The clinical diagnosis in all cases was glioma, histological examinations were not done. The patients received teleradiotherapy (DG 6000 rads) and simultaneously combined chemotherapy by the Hildebrand schedule (methotrexate, vincristine, CCNU, dexamethasone). In one case severe toxicity was observed. The median survival time was 41 weeks and 10 patients survived over one year.

Adult↗