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Biomedical subjects

M Kośmider

Publications and source records attributed to M Kośmider.

At least 19 recordsLinked to original sources
PubMed2004

Effects of a surgical treatment of congenital cervicovaginal agenesia.

OBJECTIVE: Congenital agenesis of the uterine cervix and vagina is one of the rarest congenital defects. The objective of this manuscript is to present our experience and effects of a surgical treatment in five girls with inborn agenesis of the uterine cervix and vagina, who were operated in our clinic. METHOD: The vagina is reconstructed in four stages: (1) formation of vaginal recess; (2) phantomization of vagina; (3) joining of the reconstructed vagina with the uterus; (4) revision and correction of the junction. GnRH analogs were administered to avoid menstrual blood flow into the peritoneal cavity during phantomization. RESULTS: Patency of the uterovaginal junction was maintained with a #6 intubation tube. Normal menstruation was restored in all patients. Atresion of the canal at the uterovaginal junction was disclosed after 3-8 months in three of the patients. Patency was restored with surgical hysteroscope and the canal was mechanically distended. Clinical and ultrasonographic followup in the patients will continue.

Adolescent↗
PubMed2000

A randomized comparison of elective high-pressure stenting with balloon angioplasty: six-month angiographic and two-year clinical follow-up. On behalf of AS (Angioplasty or Stent) trial investigators.

BACKGROUND: Previous randomized trials have shown beneficial effects of coronary stenting on restenosis and event-free survival rates. However, it has not yet been fully established if routine high-pressure stenting with an antiplatelet regimen can show similar results. METHODS: We compared the 6-month angiographic restenosis rate and 2-year event-free survival rate in 400 patients randomly assigned to stent or angioplasty. Aspirin and ticlopidine were prescribed in both groups. RESULTS: The procedural success rate did not significantly differ between the stent and angioplasty groups (97.92% vs 97.45%, P = not significant). No stent thrombosis was found. The 6-month restenosis rate was lower in the stent group (18. 18% vs 24.87%, P =.055). At 2 years target lesion revascularization rate was 17.19% in the stent group and 25.51% in the angioplasty group (P =.02, 33% reduction). No significant differences with regard to death and myocardial infarction were observed. Event-free survival rate at 6, 12, and 24 months was 86.77% vs 78.84%, 84.13% vs 76.70%, and 83.07% vs 73.54% for stent and angioplasty groups, respectively (P =.0172). CONCLUSIONS: The 6-month angiographic and 2-year clinical outcomes were better in patients who received stent than in those after balloon angioplasty. The difference in 2-year event-free survival rate was explained by a reduction in target lesion revascularization rate in the stent group.

Angioplasty, Balloon, Coronary↗
PubMed1999

[Can the exercise test with nitroglycerin be useful for differentiation of patients with and without changes in coronary arteries--syndrome X?].

UNLABELLED: The aim of this study was to compare the results of ECG exercise test performed before and after oral administration of nitroglycerine (NTG) in patients with coronary artery disease (CAD), and patients with typical chest pain without any changes in coronary arteriography--syndrome X. We examined 98 patients with typical chest pain, positive result of ECG exercise test, then accordingly to results of coronary arteries assessed with coronary arteriography, patients (pts.) were divided into two groups: group 1--35 pts. without any changes in coronary arteriography--syndrome X, and group 2--48 pts. with significant stenosis present in one or more coronary vessels. Each patient underwent two ECG exercise tests: first without any medication and second performed average 30 minutes after first test, and 5 min after oral administration of 1 table of nitroglycerine. During both tests the following parameters were evaluated: test duration, presence of chest pain, max. ST-T changes, heart rate (HR), and systolic blood pressure (SBP). RESULTS: In group 1 after NTG time of test duration had shortened from 5.9 +/- 0.4 min to 5.7 +/- 0.6 min. We also observed an increase in max. ST-T complex depression (2.2 +/- 0.5 mm vs 2.4 +/- 0.4 mm) but these differences were not statistically significant. In CAD group, duration of test after NTG was longer (6.2 +/- 1 vs 7.4 +/- 1.2), and normalization of max. ST-T complex depressions (2.7 +/- 0.5 vs 2.0 +/- 0.3 mm) was observed p < 0.01. CONCLUSION: Our study suggests that ECG exercise test with NTG may be useful in differentiation of patients with syndrome X and patients with typical coronary artery disease.

Adult↗
PubMed1998

[The significance of scintigraphic, echocardiographic and electrocardiographic left atrial transesophageal pacing in diagnosis of ischemic heart disease].

UNLABELLED: The aim of the study was to compare the perfusion scintigraphy (using SPECT method with Tc-99-MIBI) during left atrial transoesophageal pacing test (LAPT) with pacing electrocardiography (ECG), echocardiography (ECHO) and electrocardiography exercise test (ExT) in ischaemic heart disease (IHD) diagnostics. The effect of LATP on heart haemodynamic parameters and the correlation between scintigraphic, echocardiographic and electrocardiographic parameters during LAPT test have been also assessed. Investigations were carried out in 55 subjects (Group I: 36 patients with effort angina pectoris; group II: controls: 19 clinically healthy subjects). Coronarography was performed in 24 patients 6 weeks before or after examinations. LATP test was analyzed with ECG, ECHO and SPECT. Echocardiography did not increase significantly the LATP test diagnostic value. Perfusion scintigraphy enhanced sensitivity and predictive excluding value LATP test. These values were 93.3% v 62.9% and 90% v 59.3% respectively. LATP test assessed with ECG, ECHO and perfusion scintigraphy expressed significantly higher sensitivity and predicting excluding value in comparison to ExT. LATP test analyzed in such way was characterized by 100% sensitivity and 100% predicting excluding value. CONCLUSION: Combination of LATP with electrocardiography, echocardiography and SPECT is a non-invasive high quality method for ischaemic heart disease diagnostics.

Adult↗
PubMed1998

[The effect of pentoxifylline on oxidative metabolism in neutrophils primed with tumor necrosis factor alpha in patients with stable angina pectoris].

In 14 patients with stable angina pectoris we examined the effect of pentoxifyline (PTX) on oxidative metabolism of TNF-alpha-priming neutrophils. The control group consisted of 21 patients with stable angina pectoris without pentoxifylline administration. Blood samples for examination were taken from basilic vein (peripheral blood) and coronary sinus immediately before PTCA procedure. In PTX-group was found the significant decrease in spontaneous CL of TNF-alpha-priming neutrophils from coronary sinus blood (1231.0 +/- 119.4 mV x min), in comparison to the control group (1374 +/- 124.4 mV x min). In PTX-group was found the significant decrease in fMLP stimulated CL of TNF-alpha-priming neutrophils from peripheral blood (4219.0 +/- 707.2 mV x min) and coronary sinus blood (4322.0 +/- 664.4 mV x min), in comparison to the control group (5248.0 +/- 595.8 mV x min and 4973.0 +/- 536.5 mV x min; respectively). There were no differences between both groups in PMA stimulated CL of TNF-alpha-priming neutrophils.

Adult↗
PubMed1997

Complement activates neutrophils during PTCA procedure in patients with unstable angina pectoris.

We estimated adherence, aggregation and chemiluminescence of neutrophils as well as concentrations of C3c, C4 and C5 complement components and complement haemolytic activity (CH50) in 27 patients with unstable angina pectoris subjected to percutaneous transluminal coronary angioplasty (PTCA). The control group consisted of 12 patients with unstable angina pectoris, in whom coronary angiography was performed but PTCA was decided against for various reasons. Blood samples for examination were taken from coronary sinus and peripheral vein just before, 1 min and 20 min after PTCA or coronary angiography. We observed enhancement of neutrophil adherence, aggregation and chemiluminescence, and decrease in concentrations of C3c, C5 and complement haemolytic activity (CH50) after PTCA procedure. In conclusion we think that ischemia resulting from PTCA causes complement activation in an alternative pathway which seems to be connected with neutrophil activation.

Acute-Phase Reaction↗
PubMed1997

[Myocardial revascularization for sudden cardiac death in patients after previous coronary angioplasty].

UNLABELLED: PTCA was introduced into our hospital in June 1991. Since then till the end of 1996 emergency CABG operations were performed in fourteen patients. They were indicated because of acute myocardial ischaemia and hemodynamic deterioration that was the result of the dissection and occlusion of a coronary artery during angioplasty. There were 11 male and 3 female patients in this group aged 34 to 65 average 50 years. Twenty-three grafts were performed in total (18 saphenous, 5 using internal mammary artery), that is 1.6 graft per patient. A female patient died of myocardial infarction on the first postoperative day. All other patients survived and are under outpatient clinic's care. Over the analysed 6 years' period of time 1079 PTCAs were performed. The low rate of the unsuccessful procedures (1.3%) that required the emergency CABG is noteworthy. Since 1995, when the implantation of stents was introduced into our hospital, there were only 2 such procedures (0.4% of all PTCAs). CONCLUSIONS: The CABG operation performed shortly after a dissection and occlusion of the coronary artery underwent angioplasty usually prevents myocardial infarction and saves the patient's live. The introduction of implantation of the stents significantly diminished a number of patients who required an emergency CABG operation.

Adult↗
PubMed1996

Ischaemic episodes detected by early exercise test and Holter monitoring after myocardial infarction: which are of most prognostic value?

BACKGROUND: The aim of this study was to assess the significance of ST-segment depressions (ST-SD) detected during exercise test or Holter monitoring and to determine which parameters of ST-SD are the most important prognostic factors in patients after myocardial infarction. METHODS: The study group consisted of 164 patients (126 men and 38 women) who survived their first uncomplicated myocardial infarction. Twenty-four-hour Holter monitoring on day 10 (+/- 2) after infarction and a treadmill exercise test 1 or 2 days later were performed. The following parameters of ST-SD were taken into consideration: amplitude, localization according to the area of infarction and presence or absence of concomitant angina. Patients were observed for 24 months to assess the occurrence of new cardiac events. RESULTS: In 78 patients (group I) ST-SD were detected in both Holter monitoring and the exercise test, and in 32 patients (group II) in the exercise test only. Fifty-four patients (group III) were without ST-SD. During follow-up there were 83 cardiac events in group I, 24 in group II and 16 in group III (P < 0.01, group I versus II; P < 0.0001, group I versus III; P < 0.05, group II versus III). In multivariate analysis the presence of ST-SD during Holter monitoring or the exercise test, or both, appeared to be of most prognostic significance (P < 0.0001). The number of new cardiac events was significantly higher in patients with painful ST-SD greater than 3 mm, detected outside the area of infarction (distant ischaemia). CONCLUSIONS: This study shows a significant prognostic value of early post-infarction ischaemia detected by Holter monitoring and an exercise test. Distant, painful ST-SD greater than 3 mm were more powerful determinants of poor prognosis than others. Electrode placement during Holter monitoring appears to be very important, particularly in post-infarction patients.

Coronary Angiography↗
PubMed1996

[GnRH analogs for treatment of ovarian cancer].

To make use of antigonadotropin and antiproliferating action of the synthetic analogs of GnRH there was applied this decapeptide in 33 patients with ovarian cancer who were treated traditionally by chemotherapeutics PAC and radiotherapy. The monitoring of treatment was supported on the clinical opinion of the whole and locally state of health, the USG examinations of pelvic and diaphragm, the measure of level of CA-125 and second-look operations. There were got statistically characteristic rise of remissions and stabilizations of neoplastic process.

Adult↗
PubMed1995

[Adhesion and aggregation of neutrophils in patients with unstable angina].

The adherence and aggregation abilities of neutrophils (PMNs) were evaluated in thirty three patients with unstable angina, who were qualified for PTCA procedure. The control group consisted of forty one clinically healthy persons. The blood for investigations was obtained from coronary sinus and basilic vein just before the procedure, while in the control group from basilic vein only. The adherence of PMNs to plastic surface (rest and stimulated by PMA) was estimated in vitro according to Oez's et al. method by measuring optical density of generated formazan, whereas the aggregation of PMNs was evaluated using the leukergy test according to the method of Fleck in Berliner's and Aronson's modification. In patients with unstable angina statistically significant higher (p < 0.001) adherence of peripheral blood PMNs, compared with control groups was found (patients: rest-0.525 +/- 0.245, stimulated-0.839 +/- 0.419, control group: rest-0.260 +/- 0.129, stimulated-0.522 +/- 0.377). The aggregation of peripheral blood PMNs was significantly higher (p < 0.05) in the sick than in the control group (the sick-10.98 +/- 4.29%, controls-4.65 +/- 3.01%). No differences in investigated parameters of PMNs obtained from peripheral or coronary sinus blood were found.

Adult↗
PubMed1995

[Generation of active oxygen species by neutrophils in patients with unstable angina pectoris].

The generation of O2-. and H2O2 by neutrophils (PMNs) obtained from peripheral and coronary sinus blood was investigated in twenty four patients with unstable angina, who were qualified for PTCA procedure. The control group consisted of twenty one clinically healthy persons. The blood for the investigations was obtained from coronary sinus and basilic vein just before the procedure, while in the control group from--basilic vein only. In patients with unstable angina statistically significant higher (p < 0.05) O2-. generation by peripheral blood PMNs (at rest and stimulated), compared with the control group, was found respectively (the sick: rest--11,09 +/- 1.92; stimulated--25.48 +/- 5.76 nmol/cell/min.; healthy: rest--7.98 +/- 1.06; stimulated--13.58 +/- 1.19 nmol/cell/min). No significant differences in O2-. generation between PMNs obtained from coronary sinus or peripheral blood were found. No differences in H2O2 generation by rest PMNs obtained from coronary sinus or peripheral blood were found in patients compared with the control group. The generation of H2O2 by PMA stimulated PMNs was higher in the sick without statistical significance.

Adult↗
PubMed1994

The effect of short-term myocardial ischemia on the expression of adhesion molecules and the oxidative burst of coronary sinus blood neutrophils.

We examined the influence of transient myocardial ischemia on the number and function of neutrophils in patients with effort angina (EA). We tested fluorometrically the expression of neutrophil membrane molecules (CD11b, CD11c, CD18) and neutrophil oxidative burst using a chemiluminescence (CL) generation system. The estimations were conducted before, 1 min after and 20 min after percutaneous transluminal coronary angioplasty (PTCA) in 15 patients qualified for the treatment because of single-vessel disease. Eight EA patients subjected to coronary arteriography (CA) comprised a control group. We did not observe any marked changes in leucocytosis or lymphocyte number in peripheral blood (PB) or in coronary sinus blood (CSB) after the procedure. The percentage of granulocytes in coronary blood decreased significantly 20 min after reperfusion. No significant changes in white blood cell count were noted in peripheral blood of PTCA patients or in control CA subjects. Oxidative burst of nonstimulated and fMLP, PMA and zymosan stimulated sinus blood neutrophils was significantly depressed 1 min after inflation, and enhanced 20 min after reperfusion. We found a significant increase in the percentage of the CD11c+ neutrophils from 56.7 +/- 7.4% to 64 +/- 6.5% 20 min after inflation and postischemic decrease in the CD11c molecule expression on CSB neutrophils. Significant positive linear correlation (Rval = 0.71) between inflation time and the CD11c molecule expression on CSB immediately after reperfusion was also noted. The results may reflect local activation of neutrophils in ischemic myocardium as a response to ischemia induced increase of activating stimuli.

Angioplasty, Balloon, Coronary↗
PubMed1994

[Influence of percutaneous transluminal coronary angioplasty (PTCA) on superoxide anion generation by whole blood granulocytes in patients with unstable angina pectoris (part I)].

In twenty patients with unstable angina, the effects of percutaneous transluminal coronary angioplasty (PTCA) on superoxide anion generation by neutrophils (PMNs) obtained from ulnar vein (UV) and coronary sinus (CS) were investigated. Blood samples for the investigations were taken from CS just before the procedure, within the first minute after the last balloon inflation and 20 minutes after PTCA; from BV--just before the procedure and 20 minutes following it. The results were compared with those obtained from 12 patients with unstable angina, (in whom coronary angiography was performed, but for various reasons angioplasty was desisted from) and with those obtained from 20 clinically healthy persons. In patients with unstable angina, the significantly increased O2.- generation by PMNs from CS and BV was found at rest as well as following opsonized-zymosan stimulation, compared with healthy persons. Within the first minute after PTCA, the significantly decreased O2.- generation by PMNs from CS was observed, compared with the results before the procedure (rest.--11.29 +/- 0.73 and 10.15 +/- 0.65 nmol/cell/min., p < 0.05; stimulation--27.62 +/- 6.25 and 18.54 +/- 3.37 nmol/cell/min., p < 0.05). Twenty minutes after PTCA O2.- generation by PMNs from CS still decreased (rest--9.23 +/- 1.08 nmol/cell/min., stimulation--15.71 +/- 5.98 nmol/cell/min.). In blood samples taken from BV before and after PTCA, no statistically significant differences in O2.- generation were observed (rest--11.32 +/- 0.79 nmol/cell/min. and 10.77 +/- 1.43 nmol/cell/min.; stimulation--25.96 +/- 6.12 nmol/cell/min. and 21.15 +/- 5.47 nmol/cell/min.).

Adult↗
PubMed1994

[Influence of PTCA on neutrophil aggregation in patients with unstable angina pectoris (part II)].

In twenty patients with unstable angina, the effects of percutaneous transluminal coronary angioplasty (PTCA) on aggregation of neutrophils (PMNs) obtained from coronary sinus (CS) and basilic vein (BV) were investigated. Blood samples for the investigations were taken from CS just before the procedure, within the first minute after the last balloon inflation and 20 minutes after PTCA; from BV--just before and 20 minutes after the procedure. The results were compared with those obtained from 12 patients with unstable angina (in whom coronary angiography was performed, but for various reasons angioplasty was desisted from) and with those obtained from 20 clinically healthy persons. In patients with unstable angina the significantly higher percent of aggregated PMNs from CS as well as from BV was found, compared with healthy persons. Within the first minute after the procedure, the significantly increased percentage of aggregated PMNs from CS compared with the results before the procedure, was observed (10.50 +/- 4.06% and 18.36 +/- 7.69%, p < 0.05), but 20 minutes after, the value of the investigated parameter decreased to 5.88 +/- 2.86% and was similar to that in healthy persons. One minute after the procedure, in patients in whom PTCA was performed, the significantly decreased PMNs number in the blood obtained from CS was found, compared with the results before PTCA (4295 +/- 840 and 3850 +/- 825; p < 0.05). Twenty minutes after the procedure no further decrease of PMNs number was observed. In patients with or without PTCA no changes in the number and aggregation of PMNs obtained from BV were observed.

Adult↗
PubMed1993

[Follow up results of treatment for premature puberty (central origin)].

Distant treatment results of premature central origin puberty with chlormadinone (Polfa) were described. Premature central origin puberty was diagnosed at 19% (38/202) of patients examined with premature puberty as a initial diagnosis. Annual medium height intake 5.5 cm +/- 1.2 cm and puberty inhibition testify to proper drug doses. Hormonal treatment should be employed till patients height is 150 cm, what is usually obtained at the age 9 at half. It makes possible to obtain final height of 162 cm +/- 4.2 cm. The average menarche age of treated girls was 10- and 11 months, and the first menstruation approximately 15 months after hormonal treatment.

Body Height↗
PubMed1993

[Transesophageal echocardiograph in the evaluation of proximal segments of coronary arteries].

The study was undertaken to assess the usefulness of TEE for evaluation of morphology and flow in coronary arteries. TEE (2D, spectral and color Doppler imaging) and coronary angiography were performed in 75 patients (pts)-41 with valvular heart disease and 34 with ischemic heart disease. Proximal coronary artery stenosis was detected by coronarography in 11 pts (9--left main coronary artery, 2--right coronary artery). TEE visualization of proximal coronary arteries was possible in all pts. Echocardiographic features of artery stenosis were: the narrowing of the vessel in 2D image (9 pts), high flow velocity spectral Doppler (4 pts, mean 135 cm/s vs 55 cm/s in normal arteries) and mosaic, turbulent flow in color Doppler (10 pts). Sensitivity and specificity of TEE for coronary artery stenosis detection was respectively 81%/98% for 2D imaging and 90%/100% for color Doppler. TEE is a new, noninvasive and safe method for the evaluation of proximal coronary arteries. Detection of LMCA stenosis prior to catheterization may enhance the safety of coronary angiography.

Adult↗