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J Nadstawek

Publications and source records attributed to J Nadstawek.

29 records · Page 2Linked to original sources
PubMed1989

[In vitro studies of the effect of flunitrazepam on cellular immune parameters].

We investigated in vitro the influence of flunitrazepam concentrations ranged between 10 and 140 ng/ml on immunological parameters by using the rosette-inhibition-test and the lymphocyte-transformation-test. After addition of 30 ng/ml flunitrazepam, which is in accordance with a threshold concentration of 1 mg flunitrazepam after intravenous injection, we saw a significant decrease of the positive cells in the rosette-inhibition-test. In higher concentrations no significant changes could be observed. By the lymphocyte-transformation-test no significant evidence of immunodepression could be demonstrated in concentration usually achieved during anaesthesia or possibly after long term application in intensive care unit, independent of the used mitogenes. Thus, flunitrazepam demonstrates no immunosuppressive effect in concentrations achieved during anaesthesia or in intensive care unit as could be observed by tests of cellular immune competence. However, one has to take into consideration that only parts of the immunesystem could be examined with these tests and in vivo-investigations have to verify these results.

Cells, Cultured↗
PubMed1989

[Return of motor and mental functions following enflurane-nitrous oxide anesthesia of 1.3 MAC in various age groups].

Recovery of motor and mental functions we investigated in 60 patients at different age ranges (Group 1: 20 young patients between 20 and 35 years; Group 2: 20 middle-aged patients between 40 and 55 years) after nitrous oxide-oxygen anaesthesia in combination with enflurane of 1.3 MAC for lumbar nucleotomy. The following parameters were investigated before and up to 80 minutes after anaesthesia: simple and discriminating motor activities, the vigilance and the short and long term memory. In simple motor actions we noticed no significant differences between the three groups. By examination of discriminating motor activity, the functional capacity of Group 3 was significantly reduced in comparison to Groups 1 and 2. Nevertheless the efficiency in Group 2 was also decreased in comparison to Group 1. The postoperative vigilance was especially impaired in the elderly patients. Only 50% of the old patients were able to satisfy the asked requirements 60 minutes after extubation. The vigilance in Group 2 showed a better improvement compared to the elderly patients but was in comparison to the young patients significantly decreased. The long term memory of the old patients pointed out a considerable reduction after this kind of anaesthesia. While no distinct differences could be found between Group 1 and 2 40 minutes after extubation, a significant difference could be observed between Group 1 and 3 even after 60 minutes. The short term memory of the elderly and the middle-aged patients was considerably reduced 60 minutes after extubation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[The immune system and benzodiazepines].

Alterations of the immune-system by benzodiazepines are of minor degree in dependence of their central or peripheral activity. Regarding their central effects a modulation may be assumed via the endocrine system. In vitro and in vivo studies lead to the assumption, that benzodiazepines have a mutagenic effect, even though this hypothesis could not be confirmed by in vitro investigations. In vivo a possible mutagenic action could only be found in two patients after long term therapy. A more mitosis-inhibiting effect of diazepam was shown in in vitro studies. In animal experiments this observation could not be confirmed for the thymus. With regard to specific immunity, diazepam seems to have a stimulating effect on the T-helper cells. Locomotion and chemotaxis of human polymorphonuclear granulocytes is not influenced by anaesthetic doses of benzodiazepines. It is questionable whether benzodiazepines are of clinical importance for the immune-system of patients receiving anaesthetic doses. However, the presently generous use of benzodiazepines, e.g. on intensive care units, should be reconsidered in respect to immunological consequences.

Animals↗
PubMed1988

[Changes in immunological parameters in vitro and in vivo due to midazolam].

We investigated in vitro the influence of midazolam concentrations ranged between 0.2 and 1.6 microgram/ml on immunological parameters by using the rosette-inhibition-test and the lymphocyte-transformation-test. Additionally, in vivo studies using the lymphocyte-transformation-test and the immunomodulatory activity of serum were performed in young volunteers during experimental determination of hypnotic threshold concentration of midazolam. In vitro, no significant evidence of immunodepression could be demonstrated in a concentration range usually achieved during anaesthesia. In vivo, midazolam concentrations between 0.4-0.8 microgram/ml more likely increased than decreased the reagibility of lymphocytes. This was determined by the lymphocyte-transformation-test, especially for T-lymphocytes stimulated by the mitogens phytohemagglutinin and concanavalin A. Thus, midazolam demonstrates no immunosuppressive effect in concentrations achieved during anaesthesia as could be observed by tests of cellular immune competence. However, one has to take into consideration that only parts of the immunesystem could be examined with these tests.

Humans↗
PubMed1986

[DSA and conventional angiography compared in the angiographic diagnosis of impotence].

Twenty-three patients complaining of impotence were examined angiographically as part of their investigation. In all patients, DSA as well as conventional angiography was carried out. The purpose of this investigation was to compare the two methods with regard to their diagnostic value. By means of sequential analysis it was shown that, with an error level of 10%, DSA was superior to conventional angiography.

Adolescent↗
PubMedDate not supplied

Localization of the epileptic focus during methohexital-induced anesthesia.

A short anesthesia was provided by methohexital for painless percutaneous removal of subdural electrodes in 27 patients with medically intractable, complex partial seizures who had undergone invasive preoperative evaluation. Electrocorticographic(ECoG) recordings performed before and during the narcosis were submitted to visual (n = 27) and computerized (n = 3) analysis to obtain additional information about the location of the epileptic focus (or foci). The following observations were made: focal epileptiform potentials were induced in 24 of 27 patients (89%); (b) in 20 of these 24, the induced spikes appeared amid or were followed by isoelectric or subdelta activity. These spikes were characterized by high amplitude as well as rhythmic and synchronized appearance over a circumscribed focal area (or areas) known to be spontaneously epileptogenic. This phenomenon, termed spike-burst-suppression (SBS) pattern, allowed identification of the primary epileptic focus in many patients with temporal lobe epilepsy. Furthermore, it indicated a good outcome of epilepsy surgery. Computerized analysis of the induced synchronized spikes (n = 3) allowed further delineation of the primary site of epileptogenicity and quantitative comparison of multiple epileptic generators. ECoG recording during deep methohexital-induced narcosis is a valuable tool for lateralization and delineation of the primary epileptogenic focus.

Adolescent↗
PubMedDate not supplied

The safe use of anaesthetics and muscle relaxants in older surgical patients.

Age greater than or equal to 75 years is not a special risk for adverse outcomes after general anaesthesia on its own but an indicator of risk. Biological or physiological age expressed by preoperative health status is much more important than chronological age. The type of anaesthesia seems to play no, or only a minor role. It is, however, most important to reduce the dosage considerably. As a rule of thumb, the dosage should be reduced by 10 to 15% for every decade over the age of 40. In addition, patients must be monitored extensively intra- and postoperatively, ideally in an intensive care setting. The controversy concerning regional versus general anaesthesia should be studied further. Regional anaesthesia techniques like high spinal or epidural anaesthesia that are haemodynamically effective do not reduce morbidity and mortality postoperatively but have the risk of profound hypertension. Peripheral blockades and spinal or epidural anaesthesia without additional sedation may, however, be associated with a reduced incidence of complications. The reduced reserves of geriatric patients demand for experienced anaesthetists and surgeons as well as intense intra- and postoperative monitoring. To secure a short recovery period, we recommend administration of short-acting drugs like propofol, midazolam, alfentanil, vecuronium, atracurium or isoflurane in appropriately reduced dosages.

Aged↗
PubMedDate not supplied

Immunohistochemical demonstration of the KI-67-antigen in paraffin-embedded tumor biopsies.

10 tumor specimens were processed according to a modification of the AMeX method, which allows for paraffin embedding plus immunostaining of the slices. We used this method to determine the growth fraction of tumors using the monoclonal antibody KI-67. Results were essentially the same as those obtained when studying frozen sections. The quality of the histological slices is equal to frozen sections, but greater areas of tumor can be examined. Furthermore, this method allows for compilation of a stock of tumor specimens which can be used for further immunohistochemical studies whenever needed.

Antibodies, Monoclonal↗
PubMedDate not supplied

Injuries to the large abdominal vessels during lumbar nucleotomy.

The rare complication of iatrogenic damage to the large abdominal blood vessels during lumbar intervertebral disc operations is demonstrated by three case reports. A sudden decrease in blood pressure and tachycardia are major signs of such vessel lacerations. Due to a valve mechanism which prevents a dorsal blood leakage through the intervertebral space, early detection of this problem by the surgeon or anesthesiologist may prove to be difficult. Myocardial infarction, pulmonary embolism, abnormal volume distribution after positioning, dysfunction of circulatory regulation due to anesthesia or faulty positioning, obstruction of the subclavian artery due to false placement of chest padding, all occur more frequently and therefore must be considered and excluded. A wrong interpretation of this acute occurrence carries a mortality of 70%. Even immediate intervention by vascular surgery shows a mortality rate of 50% for this uncommon emergency. In order to prevent the disastrous sequelae to this complication, blood vessel injury should be suspected for every unexplained intraoperative decrease in blood pressure during lumbar nucleotomy. Only a rapid termination of the operation and appropriate preparation for vascular surgery can lower the mortality of this rare occurrence.

Abdomen↗
PubMedDate not supplied

[Analgosedation as an adjuvant during surgery under local anesthesia].

Twelve systemically healthy patients each (ASA risk groups 1-2) who required oral surgery under local anesthesia received the short-acting benzodiazepin Midazolam for analgosedation as well as the analgesics Pentazocin or Piritramid. Both i.v. medications are suitable as adjuvants for local anesthesia since neither clinically relevant respiratory and circular depression nor major sleepiness were observed.

Adult↗