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Biomedical subjects

K Lewandowski

Publications and source records attributed to K Lewandowski.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Function of platelets in patients with occlusive atherosclerotic arterial disease of the lower extremities].

The platelet function as well as parameters of lipid metabolism and glucose tolerance were investigated in 30 men with occlusive atherosclerotic arterial disease of the low extremities (IIIB or IV Fontaine's stage). The platelet aggregation, platelet survival, activity of intraplatelet metabolism of arachidonic acid, radiofibrinogen binding to platelet, circulating platelet aggregates and both the activity of factor VIII and the concentration of von Willebrand factor antigen in the plasma were measured. In the majority of patients the impairment of platelet aggregation with ADP, enhancement of radiofibrinogen binding to platelets and an increase of factor VIII level in the plasma were established. There was an interrelationship between platelet dysfunction and disturbances of lipid metabolism. Platelet survival was shortened in patients with moderate hyperlipidemia and correlated with a concentration of HDL-cholesterol in the serum. The radiofibrinogen binding to platelets was the most pronounced in patients with severe hyperlipidemia and correlated with a concentration of total cholesterol in the serum. The results may suggest the potential usefulness of antiplatelet drugs in patients with occlusive atherosclerotic arterial disease.

Adult↗
PubMed1993

Long-term inhalation with evaluated low doses of nitric oxide for selective improvement of oxygenation in patients with adult respiratory distress syndrome.

OBJECTIVE: To evaluate the lowest dose of inhaled nitric oxide (NO) in patients with adult respiratory distress syndrome (ARDS), which is able to improve arterial oxygenation more than 30% compared to baseline data. DESIGN: Prospective, clinical study. SETTING: Anesthesiological ICU in a university hospital. PATIENTS: 3 consecutive patients with severe ARDS according to clinical and radiological signs. INTERVENTIONS: Pressure-controlled ventilation with positive end-expiratory pressure of 8-12 cm H2O. Inhalation of NO was performed with a blender system and a Servo 300 ventilator. The lowest effective NO dose was defined by titrating the inspiratory NO dose until reaching a 30% improvement of PaO2/FiO2. This dose was used for the following continuous long-term NO inhalation; controls of efficacy by investigation of hemodynamics and blood gas exchange were performed initially and 2 times per patient after intervals of 3-5 days. MEASUREMENTS AND RESULTS: Initial NO concentrations were found to be effective at 60, 100, and 230 parts per billion (ppb). In all measurements, arterial oxygenation was found to be elevated by NO inhalation with the initially evaluated dose compared to baseline data; in parallel, the venous admixture (Qva/Qt) was reduced. The O2 delivery increased, although O2 consumption and hemodynamics did not change. In 1 patient, interruption of NO inhalation caused remarkable increase of pulmonary resistance. CONCLUSIONS: The improvement of oxygenation by NO inhalation in ARDS does not require reduction of pulmonary resistance and can be performed using low doses in the ppb range, which has to be considered as probably non-toxic.

Administration, Inhalation↗
PubMed1993

Derivatives of 2-mercaptobenzenesulphonamide. XI. Synthesis and some pharmacological properties of 2-(2-[2-(3,4,5-trimethoxybenzamido)ethylthio] benzenesulphonyl) guanidines.

Tree methods of synthesis of 2-(2-[2-(3,4,5-trimethoxybenzamido)ethylthio] benzenesulphonyl)guanidines (IVa-b, Va-XIVa, VIII-XII) are described. The results of preliminary pharmacological examinations such as acute toxicity and influence on circulatory system of compound [IVb, VIa, XIa-XIVa] and substrates [IIIc-f] are presented. Some structure-activity relationship is discussed.

Animals↗
PubMed1993

Derivatives of 2-mercaptobenzenesulphonamide. XII. Synthesis and some pharmacological properties of 2-(2-mercaptobenzenesulphonyl)imidazoline.

Synthesis of 2-[2 (alkylaminoalkylthio)-4-R1-5-R2-benzenesulphonamide]-5-R3-im idazoline [IV-IX], their hydrochlorides [IVa-IXa], as well needful substrates [IIc, III] are described. The results of preliminary pharmacological examinations such as acute toxicity and influence on circulatory system of compound IVa-IXa are presented. Some structure-activity relationship is also discussed.

Animals↗
PubMed1993

Pharmacological properties of the extract of thymus gland (Thymomodulin-TFX) and its effect on reproduction.

The effect of Thymomodulin-TFX on pentetrazole convulsions, tremorine-induced tremor, pain response to intraperitoneal acetic acid injection, hexobarbital sleeping time, isolated guinea pig ileum, isolated rat uterus, rabbit skeletal muscle response, diuresis and corneal response was tested. In addition the effect of TFX on reproduction of albino rats was investigated. In doses up to 20 mg/kg, 8 times higher than clinical doses, TFX did not reveal any unwanted effects. The results of tests widen the security margin for TFX's usage.

Animals↗
PubMed1993

[New approaches for treating skin necrosis in protein C deficiency].

A 62-year-old woman with a 8-month-history of recurrent deep and superficial vein thrombosis developed multiple areas of skin necrosis during warfarin treatment initiation. Routine coagulation tests did not revealed any abnormalities. Protein C plasma activity and concentration were significantly decreased (59.9% and 63.3% of the normal value, respectively). Antithrombin III and protein S (total and free) content were in the normal range. Initially, the adjusted dosage of standard heparin and fresh frozen plasma was administered. Thereafter, the treatment with low doses of oral anticoagulant (acenocoumarol) was reinstalled simultaneously with Protein C Concentrate (Immuno, Vienna) intravenous administration. After six days of the oral anticoagulation the therapeutic value of prothrombin time was obtained and administration of Protein C Concentrate could have been discontinued. No adverse reactions and post-transfusions complications were observed.

Female↗
PubMed1992

Major thoracic surgery during long-term extracorporeal lung assist for treatment of severe adult respiratory distress syndrome (ARDS).

Surgery in patients treated with extracorporeal lung assist (ELA) carries a high risk of life threatening bleeding complications caused by the need for systemic anticoagulation. A case report describing a successful surgical intervention for the repair of a broncho-pleural leakage by thoracotomy during ELA is presented. A newly developed heparin coated extracorporeal system was used in a patient being treated for severe adult respiratory distress syndrome (ARDS) after left sided pneumectomy. The heparin coated system allowed discontinuation of systemic heparinization intraoperatively without coagulation complications related to the extracorporeal system. This procedure was followed by resolution of the ARDS.

Adult↗
PubMed1992

[Evaluation of thrombotic risk in young men after myocardial infarction during a period of clinical stability].

The study was aimed at an evaluation of individualized indications for antithrombotic therapy for secondary prevention in a group of 40 young survivors (aged 30-40 years) of myocardial infarction, presenting a stable phase of coronary disease. The control group consisted of 19 healthy men, of approximately similar age distribution. The determinations concerned the following: in vitro ADP and collagen induced platelet aggregation, plasma fibrinogen concentration, factor VII, VIII and antithrombin III activity, protein C concentration, spontaneous fibrinolytic activity and fibrinolytic activity after venostasis, plasminogen and alpha-2 antiplasmin activity. Moreover, to determine correlations with hemostatic parameters lipids, apolipoproteins, glucose, uric acid plasma concentration as well as percentages of lipoproteins and glycolyzed hemoglobin were also studied. In the study group various hemostasis disturbances were found: an increased platelet aggregation induced by low concentrations of ADP, increased plasma fibrinogen concentration and factor VII activity, decreased protein C concentration and impaired plasma fibrinolytic activity after venostasis. Some correlations between hemostatic and lipids parameters were also observed. Results of the study have suggested necessity for the individualized antithrombotic prevention in young survivors of myocardial infarction with antiplatelet and/or anticoagulant drugs.

Adult↗
PubMed1992

Extracorporeal lung assist with heparin-coated systems.

Extracorporeal lung assist (ELA) has been recommended for the treatment of ARDS if conventional therapy fails. However, the need for nearly complete anticoagulation is a major risk factor for hemorrhagic complications. We describe our experience with 13 ARDS patients treated with ELA using heparin-coated systems (Carmeda). Maintaining partial thromboplastin time and activated clotting time within or close to the normal range, even major surgery (20 thoracotomies and 2 laparotomies) could be performed without undue bleeding complications related to anticoagulation during extracorporeal support. Eight of the 13 patients survived. The use of heparin-coated systems allows prolonged ELA with nearly physiological coagulation function, permitting major surgical intervention. It enhances the safety margin of extracorporeal gas exchange and may ultimately extend its indications.

Adult↗
PubMed1991

Derivatives of 2-mercaptobenzenesulphonamide. IX. Synthesis and some pharmacological properties of N- or S-dialkylaminoalkyl derivatives of 2-(4-chloro-2-mercapto-5-methylbenzenesulphonyl)guanidines.

Synthesis and results of preliminary pharmacological examinations such as acute toxicity and influence on circulatory system of 2-(4-chloro-2-mercapto-5-methylbenzenesulphonyl)guanidine hydrochloride derivatives containing N-dialkylaminoalkyl (V-VI, VIIb-VIIIb, Xa), or S-dialkylaminoalkyl (XI-XIII) groups, were described. Compounds VIIa-VIIIa, IX-X, XIa were isolated as free bases.

Animals↗
PubMed1991

[Acquired platelet storage pool deficiency in rheumatoid arthritis].

A 64-year-old woman with a 15-years-history of rheumatoid arthritis developed generalized hemorrhagic diathesis. Routine coagulation tests revealed a slightly diminished platelet count only. Platelet aggregation in vitro induced by ADP, collagen, thrombin, arachidonic acid and ristocetin were reduced. The patient's plasma aggregating activity was significantly diminished which was due to a decrease of the intraplatelet nucleotide pool. The number of mepacrine labelled bodies as well as dense bodies in electron microscopy was below the normal values as well. Moreover, the intraplatelet concentration of cyclooxygenase--malonylodialdehyde (MDA) and lipoxygenase pathway products were lowered. Total platelet immunoglobulin G and M contents were significantly increased. The platelet survival time (in vitro aspirin method) was slightly shortened. Finally the diagnosis of delta-acquired platelet storage pool deficiency (delta-SPD) was established and possibilities of treatment were discussed.

Arthritis, Rheumatoid↗
PubMed1991

Glucocorticoid receptors in systemic lupus erythematosus.

Glucocorticosteroids remain the major treatment modality for systemic lupus erythematosus (SLE), but their mechanism of action is unclear. Over the past decade it has become clear that glucocorticosteroid receptors play a significant role in the mechanism of glucocorticosteroid action. We studied glucocorticosteroid receptor density and affinity on peripheral blood mononuclear cells by the glucocorticosteroid binding assay in 33 patients with SLE who had taken no glucocorticosteroid for the previous 6 months and in 32 healthy controls. Patients' disease activity was measured by the SLE Disease Activity Index (SLEDAI). Glucocorticosteroid receptors on leukocytes of patients with SLE were significantly higher than in healthy controls (4419 +/- 306 vs 3369 +/- 196, p less than 0.005). The binding affinity was not different between patients and controls. There was no correlation between glucocorticosteroid receptor number and SLE disease activity.

Adult↗