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Biomedical subjects

P Gutkowski

Publications and source records attributed to P Gutkowski.

At least 19 recordsLinked to original sources
PubMed2004

Directional analysis of digitized three-dimensional images by configuration counts.

A method for estimating the orientated rose of normal directions of a three-dimensional (3D) set Z from a digitization of Z, i.e. a voxel image, is presented. It is based on counts of informative configurations in n x n x n voxel cubes. An algorithm for finding all informative configurations is proposed and an estimation procedure is described in detail for the case n= 2. The presented method is a 3D version of a method of estimating the orientated rose of binary planar images using n x n configurations. A new feature is the design-based approach, being more appropriate for biomedical image analysis than the formerly applied model-based approach.

Algorithms↗
PubMed2001

[Airway function disturbances reversibility after mitral valve replacement].

Dyspnea, cough, recurrent airway infection, hemoptysis are the most common pulmonary symptoms of mitral valve disease and heart failure. Pathophysiological mechanism of those disturbances is complex and airway status is one of the most important. The aim of the study was to assess airway function disturbances reversibility after mitral valve replacement. The study group consisted of 30 patients qualified to mitral valve surgery. Patients were assessed by clinical cardiac noninvasive investigation and airway function study. Post-operative study was performed minimum 6 months after mitral valve replacement (mean after 8 months) and again after minimum 3 years (mean after 40 months). In most of assessed--22 patients (74%) airway obstruction was noticed, in 8 patients without obstruction nonspecific histamine provocation test was performed. Increased airway reactivity was found in 4 patients only, in another 4 patients (13%) there was no airway function disturbances. After mitral valve replacement significant improvement in all cardiac parameters including NYHA functional class was observed. No airway function improvement occurred. Only small tendency to improve airway function was noticed as far as it concerns VC, FEV1, MEF50, MEF75 iTGV with exclusion of Raw. Analysis after dividing study group into 3 subgroups with increasing airway function disturbances (from predicted to hyperreactivity and obstruction) was also performed. The improvement in airways function was noticed only in 6 patient (20% studied). In patients with mitral valve disease airway function disturbances as obstruction and bronchial hyperreactivity persist in long term follow-up after mitral valve replacement.

Adult↗
PubMed1999

[Analysis of airway function in patients with mitral valve disease in various stages of progression].

UNLABELLED: The aim of the study was to assess an airway function in patients with mitral valve disease at different stages. The study group consisted of 105 consecutive patients with rheumatic mitral valve disease (21-20% pts with mitral stenosis and 84-80% with combined mitral valve disease with a stenosis prevalence). 77 (73%) females, 28 (27%) males, at a mean age 50.4 (28-68) years. EXCLUSION CRITERIA: aortic valve disease, ischemic left ventricular damage, uncontrolled hypertension, pulmonary and allergic diseases. Each patient was assessed by clinical, echocardiographic, X-ray chest, electrocardiographic examination and airway function studies. An airway obstruction was diagnosed when MEF50 < 60% of predicted value or Raw > 0.3 kPa/lxs-1. To assess airway obstruction reversibility test with fenoterol was performed. In the others nonspecific bronchial provocation test with 0.1% histamine was assessed. Similar number of patients was qualified to II (37%), III (33%) and IV (30%) NYHA functional class. Airway function disturbances were diagnosed in 98 patients (93.5% of all). In most of them airway obstruction was observed (70.5%). Bronchial hyperreactivity was detected in 24 patients (23%). Both airway function disturbances could enhance dyspnoea and fatigue. In the whole study group significant correlations between airway parameters indicating peripheral obstruction or restriction and some cardiological parameters were found. This suggests that peripheral obstruction is proportional to development of a valvular heart disease. Airway resistance which generally represents in 80-90% function of main bronchi was not correlated with any of the analysed cardiological parameters. We conclude that central obstruction is an additional and independent of development of valvular disease part of airway function disturbances.

Adult↗
PubMed1997

[Clinical use of respiration biomechanics measurements in newborns].

The aim of the study was to assess the clinical usefulness of lung mechanics measurement in newborns with respiratory distress syndrome. Total respiratory system compliance (Crs) by occlusion technique has been measured in 49 pre-term and in 13 fullterm newborns. All measurements were performed during quiet sleep, newborns were shortly disconnected from respirator and breathed through Fleisch "0". During measurements heart rate and saturation were continuously monitored. Airway pressure was measured downstream of pneumotachometer, occlusions were manually performed. Significantly lower mean Crs values were found in newborns treated with IPPV and IMV in comparison with spontaneously breathing extubated newborns and treated by CPAP. Significantly lower Crs values were found in newborns requiring higher oxygen concentrations in comparison with low oxygen dependent. The results show that newborns with respiratory distress syndrome may be clinically well characterised by Crs value.

Humans↗
PubMed1996

[Correlation of selected hemodynamic parameters of pulmonary circulation and indices of pulmonary function in patients with mitral stenosis].

The aim of this study was to test if the lung compliance and other indices of pulmonary function correlated with hemodynamic parameters in patients with secondary pulmonary hypertension due to mitral stenosis. 36 patients (mean age 50 years) with mitral stenosis (mean mitral valve area-1.2 cm2), without history of lung diseases were analyzed in the study. 16 patients (group A) were in the II-nd and 20 patients (group B) were in the III-rd and IV-th NYHA class. All patients underwent Swan-Ganz catheterization with evaluation of pulmonary pressures, resistances and pulmonary veins compliance. Pulmonary function tests (spirometry, plethysomography, lung compliance) were also performed. In both analyzed groups the pulmonary artery pressure and pulmonary vein compliance correlated significantly with pulmonary compliance.

Adult↗
PubMed1995

[Pulmonary function in patients with rheumatic mitral valve disease. Preoperative evaluation].

UNLABELLED: The aim of the study was to observe the mechanism of cardiac-airway interaction in patients with rheumatic mitral valve disease. 61 pts with combined mitral disease and 9 with isolated mitral stenosis (42 females, 28 males; mean age 47 y) were studied. They were in NYHA functional class II-IV (36 pts in II, 22 in III, 12 in IV class). Each patient was assessed by clinical, noninvasive cardiological investigation (estimation of left atrium dimension, mitral gradient, mitral area and right ventricular systolic pressure on echocardiographic examination and relative heart volume on fluoroscopy) and lung function studies i.e. spirography, plethysmography, flow-volume curve and histamine provocation test. The bronchial hyperreactivity was found in 20 pts (75% undergoing test-mean PC40 = 0.1474 mg/ml). In 7 pts histamine test was negative. The reversible airway obstruction (after 200 micrograms FNT) was observed in 43 (61%) pts. CONCLUSION: In pts with mitral valve disease we observed significant bronchial hyperresponsiveness to histamine and reversible airway obstruction with no correlation between pulmonary function parameters and cardiological status.

Adult↗
PubMed1995

[Respiratory function in myasthenic children].

Results of lung function testing in myasthenic children to be thymectomized were compared with the results in healthy children. Data of adult myasthenic patients were also included for comparison. Lung function was within normal range. It seems reasonable to widen functional diagnostics in myasthenic children by occlusion pressure and minute voluntary ventilation measurements.

Adolescent↗
PubMed1991

Effect of salbutamol on specific airway resistance in infants with a history of wheezing.

The purpose of this study was to assess the effectiveness of nebulized salbutamol in infants with a history of wheezing. Eighty-eight children aged 3-24 months with a history of wheezing were studied, in seven groups: I (n = 15) and I/A (n = 17) with elevated specific airway resistance (SRaw); II (n = 17) with normal SRaw; III (n = 23), III/A (n = 17), and IV (n = 18) with normal SRaw exposed to carbachol bronchial challenge (CBC); and V (n = 13) serving as control. Infants for groups I/A and III/A were selected to match by age and by baseline and post-carbachol SRaw values, respectively. Baseline airway resistance and thoracic gas volume (TGV) were measured plethysmographically. Specific airway resistance was selected as an index of bronchial function. Thereafter every child in groups I, I/A and II inhaled 200 micrograms of salbutamol by tidal breathing, and the children in groups III, III/A, and IV were exposed to CBC. Following positive reaction to carbachol, children of groups III and III/A inhaled salbutamol (200 micrograms, tidal breathing), and those of group IV received no drug. Controls from group V with normal SRaw received placebo (phosphate-buffered saline). Plethysmography was repeated in all children at 5 minute intervals. Following salbutamol SRaw was reduced in children with elevated and normal SRaw. In contrast, children not receiving salbutamol had unchanged SRaw value. The response to salbutamol measured by SRaw, Raw, and TGV was not significantly different in the spontaneously obstructed infants compared to those who received carbachol. In conclusion, infants with a history of wheezing do respond to inhaled salbutamol.

Airway Resistance↗
PubMed1991

[Respiratory pattern during the first year of life in children after neonatal respiratory distress syndrome].

Spirography and lung mechanics were assessed in 82 infants (20--age 3 months, 28--age 6 months, 34--age 12 months) that had acute respiratory distress syndrome. During the first twelve months a decrease of normalized lung volumes, increase of respiratory drive and airway resistance were found. A significant correlation was found between Ti, Ttot and FRCpl, and body weight. A similar relation was found between respiratory frequency and the above mentioned. The normalized respiratory index depends on the value of FRC. The respiratory cycle timing and the normalized respiratory drive (VT/Ti/kg) are airway resistance related.

Airway Resistance↗
PubMed1990

Airway responsiveness following wheezy bronchitis in infants.

The study was undertaken to assess the airway function and its response to carbachol and salbutamol in infants recovering from wheezy bronchitis. In 82 children aged 3-33 mths, free from wheeze at the time of testing, and in 14 healthy infants, airway resistance (Raw) and thoracic gas volume (TGV) were measured using a body plethysmograph. Specific airway resistance (sRaw = Raw x TGV) was calculated. Increasing doses of nebulized carbachol were applied to challenge the airways. After a positive reaction had been achieved, 0.1 mg of nebulized salbutamol was administered. Raw was monitored during the whole procedure. In 23 of the 82 children the study was repeated after nine months on average. Within this period Raw remained elevated, whereas TGV and sRaw fell considerably (TGV from 37.9 to 28.2 ml.kg-1, p less than 0.01; sRaw from 0.78 to 0.63 kPa.s-1, p less than 0.01). Airway responsiveness also dropped during the observation period (mean log provocation dose producing 50% fall (PD50) 0.026 and 0.358, p less than 0.01). In comparison with controls the study infants responded to lower doses of carbachol (mean log PD50 0.610 and 0.031, respectively, p less than 0.01). Airway responsiveness was not related to baseline airway calibre or to signs of atopy. sRaw returned to baseline 2-5 min following salbutamol. The results suggest that airways of children in a symptom-free period following wheezy bronchitis have reduced patency and reveal hyperresponsiveness to carbachol.

Administration, Inhalation↗
PubMed1989

[Functional status of the bronchial tree in infants with gastroesophageal reflux].

Airway resistance (Raw) and functional residual capacity (FRC pl) were determined by plethysmography in 17 children aged 3 to 12 months. Gastroesophageal reflux was diagnosed on the ground of longterm monitoring of esophageal pH or the X-ray examination of the stomach. No elevated airway resistance was found. In 41% of the cases FRC (per kg of body weight) was increased. This indirectly indicates the diminished small airways patency.

Airway Resistance↗
PubMed1987

Results of a prospective controlled two-dose crossover study with intravenous immunoglobulin and comparison (retrospective) with plasma treatment.

Results of a two-dose (150 vs 500 mg/kg/month) crossover study with intravenous immunoglobulin (Endobulin, Immuno) (IVIG) carried out on 12 children with primary immunodeficiency syndromes over a period of 2 years are reported. Eight children had received human plasma (20 mg/kg/month) during the 2 years prior to the IVIG study. As these children had been thoroughly monitored during plasma treatment, a retrospective analysis of these data allowed for comparison with IVIG treatment. Children on low-dose IVIG therapy had significantly (P less than 0.01) fewer days with clinical illness, e.g., sinusitis, pneumonia, diarrhea, and arthritis, than did those receiving plasma treatment. High-dose IVIG therapy led to further significant clinical improvement. Lung function tests (MEF25) improved significantly as well. The difference between high- and low-dose therapy with respect to the improvement in clinical symptoms (e.g., cold, fever, otitis) was more pronounced in children with severe clinical symptoms at the initiation of the study. Children with fewer symptoms did comparably well on high- and low-dose treatment, except for those with acute febrile illness, which was less frequent in children on high-dose IVIG. Regular monitoring of liver enzymes in the group of patients on IVIG therapy gave no indication of the transmission of viral hepatitis in the course of the 2-year IVIG treatment.

Adolescent↗