Biomedical subjects
K Szczepanski
Publications and source records attributed to K Szczepanski.
Surgical treatment of bacterial endocarditis.
Valve replacement was performed during a 7-year period in 27 patients with acute or subacute infective endocarditis. Twenty-three patients had single valve affection--16 aortic and 7 mitral--and 4 patients had affection of both the aortic and mitral valves. Eight of the patients with aortic valve lesion had congenital aortic valve stenosis and 2 of the mitral patients had mitral prolapse. Two patients were operated upon only on the echocardiographic finding of valvular vegetations. The rest of the patients were operated because of cardiac insufficiency, intractable infection or peripheral embolization. Five patients died and 22 patients (82%) were discharged. One of these patients died in the follow-up period. The remaining 21 patients all belong to class I or II (NYHA) postoperatively. There were no cases of reinfection. Emphasis is placed on the use of echocardiography in detecting valvular vegetations, and the need to take the proper surgical action as a result of this finding, even in asymptomatic patients.
Lung function and morphology after hemorrhagic shock, soft tissue trauma and regional ischemia in dogs.
Among 40 dogs submitted to 1 of 3 experimental shock procedures: hemorrhagic shock, soft tissue trauma or regional ischemia, 24 dogs fulfilled the criteria of irreversible shock, based on survival or characteristic hemodynamic and metabolic changes. The 24 dogs were studied by measurements of lung function and hemodynamics. During the shock period no impairment of lung function was observed. The pulmonary shunting ratio fell and pulmonary vascular resistance increased. The macroscopical aspect of the lungs did not differ from that of 10 control dogs. The microscopical examination of the lungs, performed after infusion fixation, revealed only a higher granulocyte infiltration in traumatic shock and more severe congestion in hemorrhagic shock.
Clinical consequences in patients with suspect cell findings on initial vaginal cytology.
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[Clinical consequences in 446 patients with primary suspicious cell findings during prophylactic treatment for uterine neck cancer].
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The incidence of complications following hysterectomy in relation to the time interval between cone biopsy of the cervix and hysterectomy.
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[Operations of the stenosis of the pyelo-ureteral junction. Personal experience apropos of 24 operated cases].
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RS-102221: a novel high affinity and selective, 5-HT2C receptor antagonist.
The 5-HT2C receptor is one of three closely related receptor subtypes in the 5-HT2 receptor family. 5-HT2A and 5-HT2B selective antagonists have been described. However, no 5-HT2C selective antagonists have yet been disclosed. As part of an effort to further explore the function of 5-HT2C receptors, we have developed a selective 5-HT2C receptor antagonist, RS-102221 (a benzenesulfonamide of 8-[5-(5-amino-2,4-dimethoxyphenyl) 5-oxopentyl]-1,3,8-triazaspiro[4.5]decane-2,4-dione). This compound exhibited nanomolar affinity for human (pKi = 8.4) and rat (pKi = 8.5) 5-HT2C receptors. The compound also demonstrated nearly 100-fold selectivity for the 5-HT2C receptor as compared to the 5-HT2A and 5-HT2B receptors. RS-102221 acted as an antagonist in a cell-based microphysiometry functional assay (pA2 = 8.1) and had no detectable intrinsic efficacy. Consistent with its action as a 5-HT2C receptor antagonist, daily dosing with RS-102221 (2 mg/kg intraperitoneal) increased food-intake and weight-gain in rats. Surprisingly, RS-102221 failed to reverse the hypolocomotion induced by the 5-HT2 receptor agonist 1-(3-chlorophenyl)piperazine (m-CPP). It is concluded that RS-102221 is the first selective, high affinity 5-HT2C receptor antagonist to be described.
Cardioplegic cardiac arrest in aortic surgery.
Cardioplegia according to Bretschneider is able to protect the myocardium during long periods of cardiac arrest and a quiet relaxed heart has in many cases of congenital heart disease been of great surgical advantage. In the last 100 consecutive aortic valve replacements in cardioplegic arrest we have lost 6 patients and none of the deaths seems to be related to the method. In our hands it has been superior to coronary perfusion.