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Biomedical subjects

M Kopera

Publications and source records attributed to M Kopera.

18 recordsLinked to original sources
PubMed2002

"True" aneurysm of the posterior communicating artery as a possible effect of collateral circulation in a patient with occlusion of the internal carotid artery. A case study and literature review.

"True" posterior communicating artery (PCoA) aneurysms are extremely rare. A case of a 63-year-old patient with a ruptured "true" aneurysm of the right PCoA associated with the occlusion of the right internal carotid artery is presented. For nine years before he suffered from subarachnoid hemorrhage, the patient had developed symptoms of transient ischemic attack (TIA) due to the occlusion of the right internal carotid artery. The left vertebral angiogram demonstrated a "true" right PCoA aneurysm and collateral flow from the right posterior communicating artery to the right internal carotid artery. The right internal carotid system was also fed by collateral circulation from the left carotid artery through the anterior communicating artery. Transcranial colour-coded real-time sonography (TCCS) demonstrated increased velocity and turbulent blood flow in both communicating arteries. The patient was operated on and the aneurysm was clipped successfully. This case report suggests that the blood flow disturbances resulting from the collateral circulation through the PCoA could be a conductive factor in the formation and development of the aneurysm. This is the first described case of a "true" aneurysm of the PCoA coexistent with the occlusion of the internal carotid artery.

Aged↗
PubMed2001

Rituximab (Mabthera, Rituxan) in patients with recurrent indolent lymphoma: evaluation of safety and efficacy in a multicenter study.

The objective of this multiinstitutional study was to evaluate the safety and efficacy of rituximab at standard four weekly doses in patients with recurrent indolent lymphoma. Thirty-eight patients entered into this study, 63% had follicular lymphoma and 61% had an IPI score of 2 or more. Median disease duration was 3 yr, median number of prior treatments was three, and 66% of patients responded to the immediate past treatment with a median remission duration of 3 mo. A total of 158 antibody doses were given, including two patients who received two courses of four infusions each. One patient developed acute respiratory failure after the second dose and required assisted ventilation. There was no immediate relationship to the antibody infusion and no evidence of infection. This complication resolved and the patient successfully completed the full course of the antibody treatment. Another patient discontinued therapy after the second dose owing to intolerable fever and painful erythema. Sixty percent of the first, and 20% of subsequent rituximab infusions were associated with infusion-related reactions including mild fever, chills, and occasional skin eruptions. Complete and partial responses were achieved in 24% and 35% of 34 evaluable patients, respectively, for an overall response rate of 59%. The median time to progression/relapse in responding patients was 16 mo (95% CI, 6.4, 25.6) compared with a median of 3 mo duration of response to the immediate previous therapy in these patients. Longer response duration post rituximab monotherapy than with previous treatment in this series of heavily pretreated patients suggests a major role for the antibody in the therapy of patients with indolent lymphoma.

Adult↗
PubMed2000

Approaches to posterior circulation aneurysms and results of the operations.

Surgical approaches and operative results in 32 operations of aneurysms of the vertebrobasilar system are presented. The orbitozygomatic and temporopolar approach was used for aneurysms of the bifurcation of the basilar artery lying high in the interpeduncular fossa. In aneurysm which neck was located less than 10 mm above or less than 5 mm below the anterior and posterior clinoid processes the pterional transylvian subtemporal and pterional anterior temporal approaches were performed. A large aneurysm with the neck lying 5 mm below the line connecting the anterior and posterior clinoid processes was operated on via pterional transcavernous approach. The used approaches made it possible to clip the aneurysms. Good and very good results were obtained in 82 per cent of cases. The perioperative mortality was 9 per cent.

Adult↗
PubMed1998

Allogeneic and autologous bone marrow transplantation in single centre experience.

Among 290 BMT procedures: 74 AML, 78 ALL, 34 CML, 6 SAA, 3 MDS, 42 HD, 35 NHL, 11 MM, and 7 solid tumours (breast or testis cancer) Allogeneic BMT was performed in 76 patients and ABMT/APBCT in 214 patients. Survival, DFS and relapse curves were calculated using the Kaplan-Meier product limit method. Variables potentially affecting survival and DFS were assessed in a multivariate analysis by the Cox proportional hazard model in a stepwise regression. The promising results were obtained in high risk adult ALL in the first CR. DFS in CR1 patients transplanted after full dose induction and high dose consolidation was significantly longer if compared to those who received dose/time reduced or postponed treatment. For CR> or =2 patients and with CNS involvement at diagnosis ABMT offers a salvage therapy that needs further improvement. In relapsed and refractory HD better results are obtained in patients relapsing > 1 year after first CR and in patients with entirely nodal localisation of this relapse. In NHL bone marrow and spleen infiltration at diagnosis appear to be an unfavourable prognostic factor.

Adult↗
PubMed1992

[Use of the Nd:YAG laser in surgical treatment of intracranial tumors].

The Nd:YAG laser was used between January 1989 and March 1991 in 63 cases of intracranial tumours, including 32 meningiomas, 16 gliomas (including 11 glioblastomas), 8 acoustic neurinomas, 11 metastatic brain tumours. In 76.2% of cases very good results were obtained. The Nd:YAG laser was found to be particular value in the treatment of vascular intracranial tumours, especially meningiomas and metastatic tumours. The ability of the Nd:YAG laser to shrink and devascularize these tumours, was useful in neurosurgical operations. The no-touch technique, minimal or no thermal effect on surrounding tissues, better haemostasis and precision allow for easier removal of acoustic nerve tumours. The Nd:YAG laser is very useful in the operations close to the very important for life areas of the brain. The major advantages of laser include reduction of mechanical trauma, reduction of blood loss, and more radical removal of intracranial tumours.

Adult↗
PubMed1984

Electron spin resonance studies of chloroquine-melanin complexes.

Electron spin resonance (ESR) studies of chloroquine complexes with synthetic DOPA-melanin, synthetic catechol-melanin, melanin isolated from bananas and humic acid were performed. Two chloroquine concentrations (5 X 10(-5) M and 1 X 10(-3) M) were used for chloroquine-melanin complex formation. ESR studies showed differences in free radicals concentration depending on melanin origin. It was demonstrated that addition of chloroquine to melanin results in broadening of the melanin ESR signal and is accompanied by changes in the integrated intensity of the analyzed melanin samples.

Catechols↗
PubMed1984

Spectroscopic studies of chemically modified synthetic melanins.

The infrared and electron spin resonance spectra of synthetic 3,4-dihydroxyphenylalanine (DOPA) and tyrosine melanins and chemically modified melanin samples were determined, and it was shown that unmodified and reduced DOPA melanins exhibited similar ir spectra. Oxidized DOPA melanins showed a higher number of carboxy groups in the sample. A significant increase of free radical content in reduced DOPA melanin and a decrease of free radical content in oxidized DOPA melanin in comparison to unmodified samples were demonstrated by the use of ESR methodology. Methylation of tyrosine melanin with an excess of diazomethane gave very rich ir spectra as compared to melanins methylated with methanol saturated by gaseous HCl. In tyrosine melanin samples the esterification of carboxy groups with methanol caused a decrease in the free radical content. When diazomethane was used, the methylated melanin samples had free radical levels reduced to only about 4% of the total observed for unmodified tyrosine melanin.

Chemical Phenomena↗
PubMedDate not supplied

[Prognostic factors in patients with intracerebral hematoma caused by ruptured middle cerebral artery aneurysm].

In a retrospective study, the authors analysed surgical outcomes in patients after intracerebral haemorrhage (ICH) as a result of ruptured middle cerebral artery (MCA) aneurysm. Between January 1989 to June 1997, 836 patients with ruptured aneurysm were admitted. Of these 207 (24.8%) patients had MCA aneurysm. Sixty-seven patients (32.4%) with MCA aneurysm had ICH. The types of ICH were classified into three groups according to CT findings on admission: A) temporal ICH (with or without a minor SAH); B) intrasylvian haematoma (with or without a minor SAH); C) ICH with diffuse SAH (SAH with cisternal clots on the side contralateral to the haematoma). The outcome was assessed according to the Glasgow Outcome Scale. Each patient was classified as having made either a good recovery including moderate disability (a favourable outcome) or a poor recovery including severe disability, vegetative state, or death (an unfavourable outcome). Overall, 31 patients (46.3%) had a favorable outcome (good recovery in 12 (17.9%) cases and moderate disability in 19 (28.4%) cases), and 36 patients (53.7%) had an unfavourable outcome (18 (26.9%) suffered severe disability, 4 (5.9%) remained in vegetative state, and 14 (20.9%) died. A temporal ICH occurred significantly more often in patients with favourable outcomes (67.7%) (p < 0.01). In patients with favourable outcomes the incidence of Grade I and II was higher (51.6%) than that in patients with unfavorable outcomes (19.4%) (p < 0.025). Surgical complications were significantly higher in patients with unfavourable outcomes (52.8%; p < 0.01). Patients who developed more than 25 ml of ICH had significantly worse outcomes (p < 0.05). Factors that could be used to predict a favourable outcome include temporal ICH, WFNS Grade I or II, absence of a surgical and postoperative complication, and a haematoma volume less than 25 ml.

Adult↗
PubMedDate not supplied

[Surgical treatment of pineal and tectal tumors from the subtentorial and supracerebellar approach].

The results of operative treatment of pineal and tectal tumours by infratentorial, supracerebellar approach were presented. There were 15 patients with pineal and 2 with tectal tumours. Clinical symptoms of the disease were as follows: signs of intracranial hypertension, tectal lesion, impairment of gait and hypoacusis. Diagnostic procedure included CT, MRI, and panangiography investigation. Application of infratentorial, supracerebellar approach enabled total resection of tumours in 14 patients (82.3%) and subtotal in 2 patients (11.8%) In 1 patient we managed to do only diagnostic biopsy (5.9%). This approach makes possible removal of pineal and tectal tumours growing in the midline toward the anterior part of III ventricle and also posterior fossa. The advantage of this approach is fact that the operation takes place below the vein of Galen. Drooping by gravity cerebellum creates enough places for microsurgical operation. During control investigation 13 patients (76%) had no announce any complaints and were without neurological disorders.

Adult↗
PubMedDate not supplied

[Dissecting aneurysm of the posterior inferior cerebellar artery].

A 23 year old woman with dissecting aneurysm of the left posterior inferior cerebellar artery located distal to the branch feeding medulla oblongata is described. Trapping of the aneurysm with the aid of 2 clips was without any influence on neurological state of the patient and prevented recurrent hemorrhage.

Adult↗
PubMedDate not supplied

[Progress in laser neurosurgery].

Nd:YAG lasers with different wavelengths are used in neurosurgery. Their great advantage is the ability of coagulation of blood vessels and delivery through flexible fiber optics . Nd:YAG laser with wavelength 1.318 microns is used, besides, to connect blood vessels and nerves. CO2 laser is the best cutting tool but requires, for delivery rigid cable. Both types of lasers cause shrinkage and vaporisation of the tumors what facilitates its removing without greater traumatisation of surrounding tissues. The introduction of sapphire contact tips to Nd:YAG and argon lasers enables application of small laser powers and diminish the area of damage in surrounding structures. Contact laser is used for destroying of tumours, coagulation of blood vessels, restoration of patency of the main arteries, interstitial denaturation of gliomas and denaturation of the nucleus pulposus in lumbar vertebral column.

Aluminum↗
PubMedDate not supplied

[A case of tophus situated in the optic nerve].

Tophi are a characteristic sign of gout. They are situated usually around joints, on tendons, in the skin, intestine and renal tubules. The authors report a rare case of tophus situated in the optic nerve and coexisting with aneurysm of the anterior communicating artery.

Calculi↗
PubMedDate not supplied

[Application of alteplase in prevention of cerebral vasospasm and its sequelae in patients after aneurysmal subarachnoid hemorrhage from ruptured cerebral aneurysm].

15 patients after SAH from ruptured cerebral aneurysm were operated on within 72 hours after SAH. During the operation after clipping of aneurysm 10 mg of rtPA was administered into basal cisterns, Control group consisted of patients who did not receive rtPA. All the patients on the basis of CT scan were classified to III grade according to Fisher's classification. Control CT scan revealed dissolution of most clots in basal cisterns. In comparison with control group the patients who received rtPA rarely experienced radiological signs of vasospasm and delayed neurological deficit.

Adult↗
PubMedDate not supplied

[A case of acoustic neurinoma in a girl aged 13].

A 13-year-old girl with large richly vascularized acoustic neurinoma is reported. The family history and clinical evidence failed to suggest neurofibromatosis in the family. The clinical syndrome included paroxysmal headaches, vertigo, loss of consciousness and left ear hearing loss. The application of Nd-YAG laser during the operation reduced bleeding and enabled radical removal of the tumour.

Adolescent↗