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Biomedical subjects

M Ostrowski

Publications and source records attributed to M Ostrowski.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Coexistence of WPW syndrome, coronary disease and segmental disorders of myocardial contraction. Diagnostic difficulties. Description of a case].

A 61 years old patient with Wolff-Parkinson-White's syndrome, and hypertension was admitted to the CCU, because of the first episode of substernal chest pain. ECG was deformed by Wolff-Parkinson-White's syndrome, type B, with accessory pathway located on the right side, without evolution. Serum enzymes remained low. Echocardiography showed akinesis of the posterior wall and hypokinesis of the lateral wall (the same contraction disorders were described in previous echocardiographical examination 5 years ago), it was observed that the first portion of myocardium to contract was the base of the right ventricle. To elucidate the etiology of the contraction disorders, scintigraphy of the heart, using Thallium 201, was performed, showing normal perfusion of the myocardium. To illustrate the dependence of the contraction disorders and abnormal depolarization pattern of the heart, echocardiographical examination was repeated, confirming the previous results, then 100 mg of Ajmaline was given to the patient intravenously, and echocardiographical examination was continued. Administration of the drug caused antidromic atrioventricular re-entrant tachycardia during which the lateral wall of the heart had been contracting properly. This case shows contraction disorders of the heart caused by the abnormal depolarization pattern, resulting from the presence of accessory pathway. It also illustrates the diagnostic difficulties in patients with Wolff-Parkinson-White's syndrome and suspected myocardial infarction, at the same time showing that scintigraphy of the heart might be very helpful in such patients. This case confirms the usefulness of echocardiography for localization of the accessory pathway.

Coronary Disease↗
PubMed1993

Comparative gross and histological effects of the CO2 laser, Nd-YAG laser, scalpel, Shaw scalpel and cutting cautery on skin in rats.

Surgical instruments capable of sealing blood vessels while incising skin were compared to standard scalpel incisions in rats and the resultant scars examined in the early stages of wound healing for both gross and histological appearances. Those instruments which provide for hemostasis appear to do so with a delay in the early phases of wound healing.

Animals↗
PubMed1992

What is the legal 'standard of medical care' when there is no standard medical care? A survey of the use of home apnea monitoring by neonatology fellowship training programs in the United States.

In treating a patient, a doctor is obliged to use the skill and care that is ordinarily used by reasonably well-qualified doctors in similar cases. In addition, the only way in which a juror may decide whether the defendant used the skill and care which the law required of him or her is from evidence presented by doctors called as expert witnesses (cf Illinois Pattern Jury Instructions). However, what should be done if expert opinions differ concerning the care that is "ordinarily used"? Home apnea monitoring (HAM) is prescribed at times for graduates of neonatal intensive care units despite the fact that indications for its use are not well established and efficacy is completely unknown. The authors attempted to determine standards for HAM as it is currently practiced in neonatology training programs. The primary teaching hospital for each of the 99 neonatology training programs in the United States was identified. Both the medical director (MD) and a neonatal intensive care unit nurse manager (RN) were asked about the use of HAM in their own nursery for four clinical vignettes. Each vignette depicted a 1000-g birth weight infant, currently 7 weeks old and ready for discharge. In three vignettes, the infant had demonstrated no apnea, mild apnea (resolved by 2 weeks of age), or moderate apnea (requiring theophylline therapy at discharge) during the hospital course. In the fourth vignette, the infant had no apnea but was to be discharged home with supplemental oxygen. For 67 of 99 training programs, paired responses of RN managers and MD directors were obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Aftercare↗
PubMed1989

Immunophenotypic and gene probe analysis of a case of Richter's syndrome.

A rare case of diffuse large cell lymphoma (DLL) arising in the stomach of a patient with long-standing chronic lymphocytic leukemia (CLL) has been examined by a combination of immunophenotypic and gene probe methods. Both the resected lymphoma and the CLL (obtained from an infiltrate in perigastric lymph nodes) expressed surface membrane markers consistent with a B-cell origin (HLA-DR+; B1+; B4+), but surface membrane immunoglobulin (SmIg) could be detected only on the CLL cells (SmIgM lambda+). Neither neoplasm expressed cytoplasmic immunoglobulin. DNA probe analysis using the Southern blot method and probes to the joining (J-H) region of the immunoglobulin heavy chain gene and to the constant (C) regions of the immunoglobulin kappa and lambda light chain genes revealed different light and heavy chain gene rearrangements in the two neoplasms. These findings suggest that the large cell lymphoma arose from a different clone than the CLL and the development of large cell lymphoma may have represented a de novo neoplastic event in a predisposed person.

Antigens, Neoplasm↗
PubMed1989

[Evaluation of right ventricular function using radioisotope angiography in patients with chronic obstructive pulmonary disease].

The aim of the study was the evaluation of equilibrium gated blood pool angiography in noninvasive assessment of right ventricular ejection fraction in 50 patients with chronic obstructive pulmonary disease. The degree of ventilatory disturbances was measured using plethysmography to calculate air flow indexes--FEV1, MEF50 and Rt and gasometric values of arterialized capillary blood--PaO2, PaCO2, pH. The used method allowed calculation of RVEF in 41 patients, which were divided into three groups according to presence of symptoms of right ventricular failure and RVEF values. In 12 patients free of RV failure symptoms RVEF was decreased (below 40%). Basing on results of this study the authors believe that this method is useful in diagnosing subclinical states of RV failure.

Aged↗
PubMed1988

Comparison of endometrial biopsy with the endometrial Pipelle and Vabra aspirator.

Endometrial biopsy can be used to evaluate women at high risk for endometrial cancer and to follow women on hormone replacement therapy. Biopsy methods may produce enough pain, however, to lower patient acceptance. The Endometrial Pipelle is a new plastic endometrial suction curette that provides a histologic biopsy. This study compared the performance of the Pipelle to that of the Vabra aspirator, a widely accepted biopsy device. Endometrial sampling using both techniques was performed on 56 patients. Both instruments provided the correct diagnosis in 50 patients (89%). The Pipelle obtained more tissue than the Vabra in 28 patients (50%) and was noted by the clinician to cause less pain in 50 patients (89%). Forty-seven patients (84%) stated that biopsy with the Pipelle was less painful than with the Vabra. These results suggest that the Pipelle is as efficacious as the Vabra aspirator and has greater patient acceptability.

Adult↗
PubMed1983

The impact of a private group practice of converting to an automated medical information system.

As hardware and software developments make medical information systems increasingly available to physicians office practices and outpatients facilities, there is a need to focus on systems installation and conversion issues. In addition to the detailed step-by-step implementation plan, the overall impact of the new system should be anticipated. The purchasers should consider such issues as new information flow and user communication patterns between patient care and ancillary and support departments; restructuring of fundamental approaches to work allocation for either batch or real-time systems; and new emphasis on any departments vital to problem-spotting and solving. At California Primary Physicians (CPP), an awareness of these changes did not develop until well after the official "live" data had passed and the staff had been successfully using the system for several months. This paper explains how the above issues have emerged and the impact they have had on CPP, and provides a framework for anticipating such matters in any system installation.

California↗