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Biomedical subjects

W Januszewicz

Publications and source records attributed to W Januszewicz.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Pheochromocytoma with hemorrhagic necrosis and rupture with symptoms of acute abdomen and shock].

A case of a pheochromocytoma with haemorrhagic necrosis resulting in signs of acute abdomen with shock is reported. Diagnosis of a ruptured adrenal tumor was made by CT scanning. Elevated urine and plasma catecholamines as well as histological examination of the removed tumor confirmed the clinical suspicion of pheochromocytoma. The patient made uneventful recovery and is asymptomatic 2 years after surgery. Ruptured pheochromocytoma as a cause of abdominal emergency is discussed in view of the existing literature.

Abdomen, Acute↗
PubMed1995

Plasma neuropeptide Y and catecholamines in women and men with essential hypertension.

Neuropeptide-Y (NPY) is a peptide proposed to modulate the effect of the sympathetic nervous system on blood pressure control and contribute to the development of essential hypertension. To assess the possible influence of gender on its role, we evaluated plasma NPY, noradrenaline (NA) and adrenaline (A) concentrations in men and women with essential hypertension. No difference in NPY concentration was found between genders, but NPY concentration was elevated in both hypertensive men and women. NA levels were similar in all investigated hyper- and normotensives, while A was increased only in hypertensive men. These results suggest various patterns of sympatho-adrenal activity in gender subgroups of patients with essential hypertension.

Adult↗
PubMed1995

[Familial occurrence of pheochromocytoma].

Familial occurrence of pheochromocytoma in mother and two sons (11 and 14 years old) is described. The diagnosis was based on biochemical tests and localization methods. Bilateral tumors were demonstrated on computerized tomographic scanning in two of our patients. No association with multiple endocrine neoplasma was found. Removal of the tumors resulted in normalization of blood pressure and biochemical parameters. The histopathological examination of the tumor confirmed the diagnosis. A possibility of familial occurrence should be considered in patients with pheochromocytoma and appropriate diagnostic tests must be performed in their near relatives.

Adolescent↗
PubMed1995

Pheochromocytoma--the catecholamine dependent hypertension.

Pheochromocytoma is a unique type of hypertension caused by excessive production of catecholamines by the chromaffin tumor. Pheochromocytoma, a potentially life-threatening disease, is a rare cause of hypertension. The incidence varies from 0.1 to 0.8% of hypertensive population. The author's experience is based on 138 patients treated in one institution from 1956 to 1995. Hormonal activity of pheochromocytoma varies considerably, influencing the pattern, of blood pressure and the clinical symptoms. It is emphasized that different other humoral mechanisms may play a role in the pathophysiology of this type of endocrine hypertension. Biochemical tests and non-invasive localizing methods are essential for the definite diagnosis of pheochromocytoma. A great progress has been made in this respect during the last three decades. Surgical removal of the tumor is the only definite therapy with low morbidity and mortality.

Atrial Natriuretic Factor↗
PubMed1995

Influence of alpha-adrenergic blockade on ventricular arrhythmias, QTc interval and heart rate variability in phaeochromocytoma.

There are strong experimental evidences that alpha 1-adrenergic stimulation significantly influences cardiac arrhythmogenesis, especially during myocardial ischaemia and reperfusion. However, anti-arrhythmic effects of alpha-blockade in humans were scarcely utilised. Thus the purpose of our study was to assess these effects in patients with phaeochromocytoma. In 22 patients simultaneous 24 h ECG and blood pressure (BP) monitoring, as well as estimation of the urinary 24 h free catecholamine excretion, were performed twice: before and during the treatment with the non-selective alpha-blocker, phenoxybenzamine. The heart rate variability was measured during four 5 min periods, at 10.00, 16.00, 22.00 and 04.00. During alpha-blockade systolic blood pressure (SBP) decreased from 137.6 +/- 23.8 to 126.5 +/- 15.7 mm Hg (P < 0.01), heart rate increased from 83.0 +/- 9.9 to 88.5 +/- 10.0/min (P < 0.02) and duration of QTc interval unsignificantly increased. Incidence of frequent or repetitive ventricular arrhythmias was significantly higher before treatment (in 9 vs 3 of 22 patients, P < 0.05). Heart rate variability significantly decreased during the treatment, with regard to all parameters, representing both the sympathetic and parasympathetic activity. We conclude that non-selective alpha-blockade significantly decreases the incidence of frequent or repetitive ventricular arrhythmias in patients with phaeochromocytoma, although the lack of QTc interval shortening suggests that the effect of class I drugs may participate in the anti-arrhythmic effects of phenoxybenzamine. Moreover, non-selective alpha-blockade in phaeochromocytoma significantly diminishes vagal activity.

Adrenal Gland Neoplasms↗
PubMed1994

Postural stimulation test in patients with aldosterone producing adenomas.

OBJECTIVE: The purpose of this study was to evaluate the postural stimulation test before and after surgical treatment in patients with aldosterone-producing adenomas. DESIGN: The retrospective study was made on patients with aldosterone producing adenomas. PATIENTS: The postural stimulation test was analysed in 60 patients with surgically proven aldosterone producing adenoma and in 15 healthy volunteers. MEASUREMENTS: The postural stimulation test was based on measurements of plasma aldosterone, cortisol and renin activity (PRA) at 0800 h and at noon after 4 hours ambulation. RESULTS: The patients were divided into two groups according to the individual pattern of plasma aldosterone concentration following the postural test. Plasma aldosterone concentration decreased or did not change after 4 hours of standing in 42 patients (group 1, 70% of total) and increased in 18 patients (group 2, 30% of total). Mean plasma aldosterone was significantly higher in group 1 than in group 2 (1325 +/- 164 pmol/l (mean +/- SE) and 538 +/- 53 pmol/l, respectively). Mean plasma cortisol concentration after 4 hours of upright posture in both groups remained low (242 +/- 35 vs 401 +/- 63 nmol/l (group 1) and 317 +/- 46 vs 367 +/- 43 nmol/l (group 2)). Mean PRA in both groups was suppressed after 4 hours of upright posture (0.2 +/- 0.04 vs 0.2 +/- 0.04 pmol/l/s and 0.3 +/- 0.06 vs 0.1 +/- 0.02 pmol/l/s, respectively). CONCLUSION: Diverse changes in plasma aldosterone and cortisol found in response to the postural test may indicate pathogenetic heterogeneity amongst patients with aldosterone producing adenomas and should be considered during diagnosis of primary aldosteronism.

Adenoma↗
PubMed1994

Elevated endothelin-1 plasma concentration in patients with essential hypertension.

BACKGROUND: Endothelin-1 (ET-1) may play an important role in the development and maintenance of hypertensive states. In patients with essential hypertension, ET-1 plasma concentration increases or remains unchanged. The aim of the present study was to investigate ET-1 plasma concentration in patients with mild-to-moderate essential hypertension and its interrelationship with catecholamines, neuropeptide Y and atrial natriuretic peptide (ANP). METHODS: The study included 37 patients (mean age 38.2 +/- 1.6 years) with mild-to-moderate essential hypertension. The control group consisted of 21 healthy volunteers (mean age 35.6 +/- 1.4 years). ET-1, neuropeptide Y and ANP were determined by radioimmunoassay methods and catecholamine plasma concentration was determined radioenzymatically. RESULTS: Our study shows that plasma ET-1 and neuropeptide Y levels are elevated in patients with essential hypertension compared with a control group. No correlation was found in either of the groups between plasma ET-1 level and plasma neuropeptide Y, catecholamine or ANP concentrations. CONCLUSION: Our results suggest that ET-1 is relevant in the development and maintenance of elevated blood pressure.

Adult↗
PubMed1994

[Giant cell arteritis--presentation of 3 cases].

Three patients with giant cell arteritis (GCA) observed recently in our department are described. One of them demonstrated clinical picture of polymyalgia rheumatica, the other two presented with clinical symptoms of GCA. This presentation seems to be very helpful for correct diagnosis in cases with difficult recognition.

Aged↗
PubMed1993

[Influence of chronic ketanserin therapy on blood pressure and certain humoral and metabolic factors in patients with mild to moderate primary essential hypertension].

Ketanserin, a serotonin-2-receptor antagonist, was administered to 16 patients with mild to moderate essential hypertension in randomized single-blind placebo controlled study. After 2 weeks of placebo administration ketanserin 60 mg daily was given for 3 weeks. In 7 patients the normalization of blood pressure was obtained and they were given the same daily dose of ketanserin for another 3 weeks. In the remaining 9 patients the dose of ketanserin was increased to 120 mg daily for the same period; in one additional case blood pressure decreased to normal. In the whole group the decrease of diastolic pressure was statistically significant comparing to placebo period. Ketanserin therapy did not influence serum free serotonin concentration, but the hypotensive effect was greater in patients with lower serotonin blood levels. Serum aldosterone concentration decreased in the initial period of treatment; the decrease was more pronounced in patients who responded to therapy. In this subgroup of patients diastolic blood pressure correlated positively with plasma renin activity. Ketanserin lowered serum adrenaline concentration, particularly in patients with good response to therapy. There was also decrease of total cholesterol concentration without any significant changes in HDL--cholesterol fraction. The authors conclude that oral chronic ketanserin treatment is an effective therapy in essential hypertension and that its effectiveness is greater in patients with lower serum serotonin levels. The hypotensive effect of the drug may be connected with lower sympathetic activity and with changes in renin-angiotensin-aldosterone system. Ketanserin is well tolerated and exerts beneficial effect on lipid metabolism.

Administration, Oral↗
PubMed1992

Plasma atrial natriuretic peptide (ANP) concentration in patients with pheochromocytoma.

The interaction between catecholamines (CA) and ANP is not clearly established. The effects of excess endogenous CA on ANP secretion can be investigated in patients with pheochromocytoma. We studied 27 patients with surgically and histologically proven pheochromocytoma (P) aged 19-70 years. In 16 of these patients plasma ANP study was repeated after surgical removal of the tumour. The control group (C) consisted of 20 healthy volunteers aged 21-48 years. Moreover, 42 patients with uncomplicated mild to moderate essential hypertension (EH) aged 18-48 years were also studied. In P higher plasma ANP concentration versus C, EH was found (51.9 +/- 8.1; 25.5 +/- 1.5; 19.3 +/- 1.5 fmol/ml, respectively). In 16 patients with P, increased plasma ANP level (mean 63.3 +/- 12.6 fmol/ml) declined after surgical removal of the tumour (mean 22.4 +/- 2.9 fmol/ml). In the P patients no relationship was found between plasma ANP and hormonal patterns of the tumour or between plasma ANP and plasma catecholamines, whereas significant positive correlations between plasma ANP and both systolic and diastolic blood pressure and heart rate were demonstrated. These results suggest that excess CA produced by the chromaffin tumour induce ANP secretion via stimulation of adrenergic receptors. However, influence of the haemodynamic changes evoked by CA cannot be excluded. It is suggested that increased secretion of ANP may be of some importance in maintaining blood pressure homeostasis in patients with pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1992

[Primary arterial hypertension. Treatment with captopril and function of the left heart ventricle, concentration of catecholamine in blood and activity of renin].

We evaluated the effect of captopril treatment on left ventricular mass (LVM) and function in sustained mild-to-moderate primary hypertension. In 16 men aged 34.5 +/- 6.4 yrs. M-mode echo and pulsed wave Doppler recordings were obtained prior to and after 2 months captopril treatment (50-150 mg daily). No significant changes in heart rate, systolic blood pressure, ejection fraction, fractional shortening, cardiac output, LVM and Doppler-derived indices of mitral inflow were observed. Diastolic blood pressure measured during examination fell from 102.2 +/- 13.3 to 90.3 +/- 9 mmHg (p less than 0.026). No consistent correlations between catecholamines and indexes of left ventricular function were found. Two-month captopril therapy in mild-to-moderate hypertension results in diastolic blood pressure lowering with no effect on LVM or left ventricular function.

Adult↗