Biomedical subjects

Ludomir Stefańczyk

Publications and source records attributed to Ludomir Stefańczyk.

12 recordsLinked to original sources

PubMed2005

[Color Doppler imaging of the retrobulbar circulation in non-exudative and exudative age-related macular degeneration].

PURPOSE: To study ocular perfusion in the ophthalmic artery, central retinal artery, nasal and temporal posterior ciliary : arteries in non-exudative and exudative age-related macular degeneration. MATERIAL AND METHODS: Twenty five subjects with non-exudative age-related macular degeneration were compared to twenty five subjects with exudative age-related macular degeneration and to twenty five age-matched control subjects. Color Doppler imaging measured peak systolic velocity (PSV) and end diastolic velocity (EDV) in the ophthalmic artery, central retinal artery, nasal and temporal posterior ciliary arteries of one eye. The resistivity index (RI) and the pulsatility index (PI) were calculated. RESULTS: There were statistically significant differences between: subjects with non-exudative age-related macular degeneration and subjects with exudative age-related macular degeneration in EDV, RI and PI in the ophthalmic artery and PSV in the temporal posterior ciliary artery, subjects with non-exudative age-related macular degeneration and control subjects in RI in central retinal artery, subjects with non-exudative age-related macular degeneration and control subjects in RI and PI in nasal posterior ciliary artery, subjects with exudative age-related macular degeneration and control subjects in PI in nasal posterior ciliary artery. CONCLUSIONS: The study results showed reduced ocular blood flow in patients with non-exudative age-related macular degeneration compared to patients with exudative age-related macular degeneration and to control subjects. The higher RI in central retinal artery in non-exudative age-related macular degeneration compared to control subjects, suggest there may be a more generalized perfusion abnormality beyond the choroid.

Case-Control Studies↗

PubMed2005

Applicability of ultrasound in ocular tumors in children and adolescents.

PURPOSE: Evaluation of the applicability of ultrasound in children diagnosed for neoplasm of the eye. Evaluation of Doppler ultrasound in visualizing blood vessels within the lesion in eye ball, eye socket and eye lids. Establishing the value of the obtained data concerning the image of vessels and blood flow for the diagnosis, monitoring the course of disease and results of treatment. MATERIAL AND METHODS: The study comprised 80 patients diagnosed and treated for neoplasm of the eye. The study group included 48 girls and 32 boys aged 2 weeks to 18 years. All the patients were subject to full ophthalmologic examination, ultrasound and other imaging techniques. RESULTS: Echogenicity of lesions, focality of growth and the comparison of echostructure did not allow for establishing the degree of malignancy. The presence of vessels in tumor mass and blood flow in tumors were useful for differentiation between malignant and benign tumors. CONCLUSIONS: Ultrasound methods used significantly improve diagnostic possibilities in orbital tumors in children. The obtained pictures of vessels and flow character are typical for some tumors, which together with histopathology of tumors enables establishing of correct diagnosis. CD/PD ultrasound is helpful in monitoring treatment of selected orbital tumors, enables evaluation of biological evolution of capillary hemangioma and assessment of vascularization degree of tumors treated with chemo- and radiotherapy.

Adolescent↗

PubMed2005

[Mono- and multislice computed tomography of the orbita injury].

PURPOSE: To evaluate the reliability of the mono- (SCT) and multisliced CT (MSCT) imaging and their post-processing reconstructions in the cases of orbital trauma. MATERIAL AND METHODS: the spiral monoslice (n=20) and spiral multisliced (n=5) CT studies were performed in patients suffered from orbits' injuries. CT data were reconstructed in the 2D and 3D mode. The CT original images and the 2D and 3D reconstructions were evaluated according to the quality of visualization of a pathological lesions. Surgery was the method of reference. RESULTS: The reconstructed 3D images in 16 patients examined in SCT mode and in 5 patients examined in MSCT mode allowed to recognize properly the fracture. In the 13 patients SCT and in the 3 ones MSCT revealed the bone fragments and orbital soft tissues prolapse towards maxilla sinus; including the lower rectus muscle in 6 cases. In 1 patient evaluation of the 3D model allowed to exclude communication with intracranial space. The surgery correlated well with the source images and 2D/3D SCT and MSCT models. The diagnostic quality of the raw SCT vs MSCT images was evaluated as equal, but MSCT proved to be the better source for the post processing reconstruction, because of higher resolution and better smoothing. CONCLUSIONS: - Spiral CT 2D and 3D reconstructed images, especially generated from the MSCT, more clearly than the source data depict anatomical spatial relationships; - 2D/3D reconstructions revealed the position, course and displacement of a fractured fragments; thus it supports the surgery.

Humans↗

PubMed2005

Recurrent cerebral gliomas in MRI and Iodine-123[corrected]-alpha-methyl-tyrosine SPECT: the use of digitally fused images.

BACKGROUND: Early detection and site location of recurrent cerebral glioma helps design optimum therapeutic regimen, which contributes to prolonged survival time of the patients. However, diagnosing the neoplastic growth at the post-resection site is a difficult process. The diagnostic modality to provide the most extensive morphological data is dynamic MR tomography. On the other hand, the tumour-related metabolic changes can be best diagnosed using the PET and SPECT techniques of nuclear medicine that employ radiolabelled amino acid 131 I-alpha-metyl-tyrosine (IMT) as the tracer. Thus, for comprehensive diagnostics of brain tumours, it is most effective to combine both the modalities and evaluate the fused images. The aim of the present study was to verify the usefulness of the calculated algorithm for a digital fusion of RM/SPECT images for the assessment of post-resection site of cerebral gliomas. MATERIAL AND METHODS: The findings of MR and SPECT imaging for 21 patients who had surgery for cerebral glioma were subject to assessment. Diagnosis was based on histopathology results (8 cases of anaplastic astrocytoma and 13 cases of multiform glioblastoma). The site and size of the contrast enhancement areas from MR was compared with the hot focus location from SPECT. RESULTS: The study confirmed the feasibility of digital fusion of images yielded by SPECT and MR. The fused images reflect the non-homogeneity of the post-resection site of cerebral gliomas. Contrast enhancement areas only partially overlapped with the hot foci which, furthermore, were found to be substantially smaller. CONCLUSIONS: The consistency of tumour locations detected with MR and SPECT was higher for tumours of the anaplastic astrocytoma type than for multiform glioblastomas (higher polymorphism of pathological changes).

Adult↗

PubMed2004

Cortical mapping by functional magnetic resonance imaging in patients with brain tumors.

The aim of our study was to establish the effectiveness of the functional MRI (fMRI) technique in comparison with intraoperative cortical stimulation (ICS) in planning cortex-saving neurosurgical interventions. The combination of sensory and motor stimulation during fMRI experiments was used to improve the exactness of central sulcus localization. The study subjects were 30 volunteers and 33 patients with brain tumors in the rolandic area. Detailed topographical relations of activated areas in fMRI and intraoperative techniques were compared. The agreement in the location defined by the two methods for motor centers was found to be 84%; for sensory centers it was 83%. When both kinds of activation are taken into account this agreement increases to 98%. A significant relation was found between fMRI and ICS for the agreement of the distance both for motor and sensory centers (p=0.0021-0.0024). Also a strong dependence was found between the agreement of the location and the agreement of the distance for both kinds of stimulation. The spatial correlation between fMRI and ICS methods for the sensorimotor cortex is very high. fMRI combining functional and structural information is very helpful for preoperative neurosurgical planning. The sensitivity of the fMRI technique in brain mapping increases when using both motor and sensory paradigms in the same patient.

Adult↗

PubMed2004

[The application of functional magnetic resonance imaging for the assessment of localisation and activation of cortex smell centers depending on stimulus used in normal volunteers].

PURPOSE: To determine the location and activation of brain smell centres in response to olfactory nerve-mediated and combined olfactory and trigeminal nerve-mediated stimulation using functional MRI. SUBJECTS AND METHODS: MRI brain scans were performed in 10 healthy volunteers, aged 22-36 years, right handed, non-smokers, without any CNS diseases, not taking any medication to determine and compare the activated cortex regions during stimulation by patchouli and geraniol. fMRI was performed on Siemens Magnetom Vision 1,5 T imager with a head-neck coil using SE and EPI sequences. Functional MR imaging studies were obteined in the same plane as T11 eighted images in an axial plane by using echo planar imaging. In each of 14 contiguous planes parallel to anterior-posterior commisure line images that depicted blood-oxygen-level-dependent (BOLD) effect were acquired. The subject inhaled odorized air through both nares for 30 seconds. During 30-second off period the subject received room air at the same flow rate. For each of activated cortical zones the number of pixels activated was calculated. Image reconstruction and analysis were performed using standard imager software installed in MR imager. RESULTS: The exposure to the olfactory and trigeminal nerve-mediated stimuli showed more activated regions than to the olfactory nerve-mediated stimuli. Geraniol evoked the biggest activation in orbitofrontal region, cingulate gyrus and insula. Patchouli activated orbitofrontal cortex, insula, parahippocampal gyrus, occipital cortex, and corpus callosum. CONCLUSIONS: The results of present study confirm the ability to localize patterns of cortical activity with fMRI during olfactory tasks.

Adult↗

PubMed2004

[Persistent left superior vena cava].

Persistent left superior vena cava -- a case report. A case of a 72-year-old female admitted for pacemaker implantation is presented. During the procedure, persistent left superior vena cava was found. Pacemaker was inserted via right subclavicular vein.

Aged↗

PubMed2004

Assessment of clinical usefulness of 131I alpha-methyl-tyrosine and fused SPECT/MRI imaging for diagnostics of recurrent cerebral gliomas.

BACKGROUND: Early detection and diagnostic differentiation of neoplastic tissue from necrotic changes and scars following the treatment of cerebral gliomas is essential for determining further therapy and prognosis. The primary technique used for the diagnostics of recurrent neoplastic growth is the magnetic resonance imaging (MRI), which in some cases, however, does not allow one to identify the character of cerebral lesions. Recently, MRI has been supplemented with single-photon emission computed tomography (SPECT) or positron emission tomography (PET) employing radiolabelled amino acids. e.g. tyrosine or methionine. The aim of the project was to assess the diagnostic potential of SPECT when iodine-131 alpha-methyl tyrosine (IMT), a Polish make of radiopharmaceutical (OBRI--POLATOM, Otwock-Rwierk, Poland), was applied. The use of 131I as a substitute for the more costly, imported iodine-123 has been justified in view of the nature and significance of the diagnostic problem on the one hand, and the possibility of 131-iodine application on a larger scale in CEE countries, on the other. MATERIAL AND METHODS: MRI and SPECT were performed in 24 patients with a history of surgical treatment and radiotherapy of cerebral glioma (WHO grade II/IV). A SPECT was carried out 15 min after an i.v. injection of 74-111 MBq IMT. The tomograms were evaluated visually and in quantitative terms. The fused SPET/MR images were also analyzed. The obtained results were verified against histopathological findings, control MRI examinations and the clinical course of disease within 7-28 months of monitoring. RESULTS: In 19 patients, an increased IMT uptake indicative of a recurrent tumour was found, and the presence of the tumour was confirmed. In five patients no hot spots were detected which would indicate the neoplastic growth and verification did not provide any evidence for relapse. CONCLUSIONS: The examination employing iodine-131 IMT made it possible to confirm or exclude tumour recurrence in all the subjects, also in the cases when the CT/MR images were inconclusive. The MRI/SPECT fusion made it possible to more accurately identify the location of tumour recurrence as well as determine the area for spectroscopic MR analysis, for stereotactic biopsy and radiotherapy.

Adult↗

PubMed2003

[Usefulness of Doppler ultrasound imaging in monitoring of hypoxic-ischemic encephalopathy in preterm infants].

Cerebral blood flow disregulation could be one of the main causes of hypoxic-ischaemic encephalopathy (HIE). It is difficult to differentiate between sonographic appearance of immature periventricular white matter of premature neonate and changes of HIE type. Therefore the diagnostic and prognostic value of doppler ultrasound resistance index (RI) examination in anterior cerebral arteries of premature infants with early sonographic signs of periventricular white matter hyperechogenicity was the aim of the study. The study group consisted of 23 premature infants: birth weight 1550 +/- 570 g, gestational age 24-32 weeks, Apgar score 2-7 points, of which 19 were ventilated. Doppler ultrasound imaging was performed twice: during the first 24 hours of life and 3 weeks later. As not all infants survived to the time of control examination, the final study group consisted of 17 subjects. Doppler examination of premature infants having finally sonographic signs of HIE (n = 12) revealed that RI value in this group of infants was increased during initial as well as the next examination. In the group of premature infants having finally normal sonographic scan (n = 5), doppler examinations showed that RI value stayed in normal limits or was slightly decreased all the time. We conclude that doppler imaging of premature infants could be important diagnostic and prognostic tool in differentiating between the ultrasonographic view of immature periventricular white matter and real HIE. Doppler imaging is useful in identification of patients having increased risk of HIE and supplements routine transfontanellar ultrasound in estimation of HIE progression.

Brain↗

PubMed2003

[The impact of hormone replacement therapy applied in women with varicose vein on changes in coagulation and fibrinolysis].

UNLABELLED: In fifty two postmenopausal women (study group: n = 20 with varicose vein; controls: n = 32) with climacteric symptoms some changes in fibrinolytic and coagulative parameters were measured during six months of HRT consisted of transdermal oestradiol (17 beta-E2) and oral medroxyprogesterone acetate (MPA). Additionally, sonographic examinations of the venous system of pelvis minor and low extremities were performed three times in every women--at baseline, in the 3rd and the 6th month of the trial. In the 3rd month the varicose vein group exhibited lowered INR and t-PA, but the in 6th month increased D-dimer as compared to the controls. No sonographic signs of venous thromboembolism were detected. CONCLUSIONS: 1) Postmenopausal varicose vein women taking combined HRT (17 beta-E2 plus MPA) are on slightly increased additional risk of venous thromboembolism, 2) in monitoring of these patients sonographic evaluation of the venous system of low extremities and pelvis minor and well as D-dimer in blood serum should be done.

Administration, Cutaneous↗

PubMedDate not supplied

[Brain metabolism alterations in patients with anorexia nervosa observed in 1H-MRS].

The causes of metabolic brain changes in patients with anorexia nervosa are still not fully explained. The purpose of this study was to use the 1H-MRS method in investigating metabolic changes in the brain of patients with anorexia nervosa. We studied 10 patients for visible alternations in brain metabolism and compared the results to healthy controls. 1H-MRS was acquired by the method of single voxels in white and grey matter. Proton MRS was performed after image guided localization using stimulated echo acquisition mode (STEAM) sequence with a short echo time of 20 ms. For data evaluation we used standard Siemens software and the additional PC. Choosing of the MRS sequences was related with particular interest in metabolites of short time echo: myoinositol and lipids. Besides this we evaluated peaks of: N-acetylaspartate (NAN), creatine (Cr) and choline (Cho). The results show significant differences in the levels of metabolites connected with fatty metabolism. In white matter we observed the reduction of lip-peak. The data was evaluated approximately and presented as lip:Cr. We did not observe any differences in other metabolites. As far as we know similar results had been reported and our study confirmed significant disorders in metabolism of these chemicals in patients with anorexia nervosa.

Adolescent↗

PubMedDate not supplied

[The usefulness of fused MRI and SPECT images for the voxel positioning in proton magnetic resonance spectroscopy and planning the biopsy of brain tumors: presentation of the method].

BACKGROUND AND PURPOSE: Progress in neurooncology suggests a need to combine information from anatomical-morphological and functional imaging in diagnosis and management. It is not always possible to establish a correct diagnosis using MRI imaging techniques alone, especially in the case of recurrent brain tumors. It is suggested that the results of different imaging techniques should be combined especially in these circumstances. The aim of this study was to evaluate the usefulness of fused post gadolinium MRI and single photon emission tomography (SPECT) images for planning 1H MRS. MATERIALS AND METHODS: 19 patients with a histopathological diagnosis of glial brain neoplasms were examined. SPECT was performed after i.v. administration of iodine-alpha-methyltyrozine (IMT). Fused SPECT and post Gd MR images were obtained on a peripheral console (Linux, PC), using a self developed technique. 1H MRS was performed on a 1.5 T scanner with the single voxel (SVS) technique using STEAM (TE 20 ms, TR 2000 ms) and (PRESS TE 136 TR 2000 ms) sequences. RESULTS: 1H MRS with a volume of interest positioned in the most metabolically active areas on fused images, gave a more accurate diagnosis of tumor type and grade that was clinically relevant in 3 patients. CONCLUSIONS: The authors conclude that planning 1H MRS with the use of fused MRI and SPECT images improves the diagnosis.

Adult↗