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Biomedical subjects

T Hryniewiecki

Publications and source records attributed to T Hryniewiecki.

At least 19 recordsLinked to original sources
PubMed2002

Effect of hypothermia on insulin-receptor interaction in different rat tissues.

Experimental hypothermia caused extensive changes in the number of both classes of insulin receptors in different rat tissues. In the liver, the number of high affinity insulin receptors (HAIRs) decreased by 50% (from 25.3 to 12.6 fmol/mg membrane protein), whereas number of low affinity insulin receptors (LAIRs) was almost unchanged in comparison to normothermic animals (5.63 and 4.39 pmol/mg, respectively). In the adipose tissue, number of both classes was reduced--HAIRs by 81% (from 24.0 to 4.50 fmol/mg) and LAIRs by 92% (from 16.0 to 1.29 pmol/mg). In the skeletal muscle, capacity of HAIRs was not changed (16.2 and 19.3 fmol/mg in normo- and hypothermic animals, respectively), whereas number of LAIRs increased by 150% (from 6.65 to 16.6 pmol/mg). Hypothermic rats also showed lower amount (by 85%) of LAIRs in the heart muscle (9.37 and 1.43 pmol/mg in control and experimental animals, respectively). Simultaneously, no significant changes were found in HAIRs (16.3 and 11.9 fmol/mg, respectively) and LAIRs (4.43 and 3.88 pmol/mg, respectively) in the brain. These differences in insulin receptors responses to hypothermia may reflect different physiological role of insulin in the regulation of target cell metabolism and/or the differences in tissue distribution of the insulin receptor isoforms.

Adipose Tissue↗
PubMed2001

[Attempt of estimation of Q fever endocarditis frequency in Poland].

Up to now no Q fever endocarditis (caused by rickettsia Coxiella burnetii) has been diagnosed in Poland. Potential endocarditis caused by Coxiella burnetii strains can be related to a group of strains present in Poland or sensitivity of Polish Population. The aim of the study was to estimate frequency of Q fever endocarditis is patients of National Institute of Cardiology and to characterize Coxiella burnetii strains and correlation between frequency of Q fever endocarditis and the group of strains. In all patients infective endocarditis and valvular heart disease were diagnosed. In all cases vegetations on TTE or TEE and negative blood cultures were confirmed. No fungal antigens or elevated anti-Candida and anti-Aspergillus antibodies were found. Serological investigations as far as it concerns C. burnetii antibodies were negative in all cases. No Coxiella burnetii infection were found in patients with infective endocarditis and negative blood cultures in the National Institute of Cardiology. However due to high probability of occurrence of such an infection in Poland further investigations in other centers would be useful.

Antibodies, Bacterial↗
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↗
PubMed2000

Evaluation of serum cytokine concentrations in patients with infective endocarditis.

BACKGROUND AND AIM OF THE STUDY: Early diagnosis of infective endocarditis is important for clinical outcome, as mortality increases if diagnosis is delayed. Diagnosis is based on clinical features, echocardiography and blood culture findings, but negative blood cultures have been reported in 5-15% of proven cases. The study aim was to investigate serum cytokine levels in patients with infective endocarditis, and the possible use of these data in diagnosis and monitoring of the disease. METHODS: The study group comprised 40 patients with acquired rheumatic valvular heart disease and ongoing infective endocarditis. A diagnosis of infective endocarditis was established by clinical examination, echocardiography, laboratory investigations (inflammatory parameters) and positive blood cultures (n = 34). Two control groups included patients with acquired rheumatic valvular heart disease: 15 without infective endocarditis, and 15 with active urinary tract infection with significant bacteriuria. Serum interleukin-1alpha (IL-1alpha), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) levels were measured on three occasions during antimicrobial treatment (mean period 14 +/- 7 days). RESULTS: Serum IL-1alpha and TNF-alpha levels were not elevated in the study group, or in controls (IL-1alpha <3.9 pg/ml; TNF-alpha <10 pg/ml). Serum IL-6 levels were elevated on all occasions in patients with infective endocarditis (first measurement: 37.0 +/- 44.3 pg/ml; second 18.7 +/- 16.4; third 8.5 +/- 5.2) with a significant tendency to decrease during treatment (p <0.01, ANOVA). In all controls without infection the serum IL-6 concentrations were below calibration range (<3.2 pg/ml). In the control group with active urinary tract infection, IL-6 concentrations were slightly (but not significantly) elevated (4.49 +/- 1.82 pg/ml, p = NS). CONCLUSION: Elevated serum IL-6 levels may suggest ongoing infective endocarditis and might be used to aid in diagnosis and monitoring of treatment of the disease. Serum IL-1alpha and TNF-alpha levels were not affected. A further understanding of the role of serum cytokine concentrations in the diagnosis, prognosis and monitoring of infective endocarditis might be valuable in clinically uncertain diagnoses, especially when blood cultures are negative.

Echocardiography↗
PubMed2000

Age dependent changes of insulin receptors in rat tissues.

Aging is associated with insulin resistance but the exact molecular mechanism is still unknown. Tissue insulin resistance can be evoked by the decreased sensitivity to insulin, the decreased responsiveness to hormone or both. As the first step in insulin action is its binding to alfa subunits of the receptor we, therefore, studied the insulin binding kinetics in plasma membranes of the liver, heart and skeletal muscle in order to establish whether their ability to bind the hormone is altered with aging. Plasma membranes were prepared and purified according to Havrankowa and binding assay was performed using (125I)-iodoinsulin. The kinetic parameters of the hormone-receptor interaction were analysed by the method of Scatchard using the LIGAND-Pc v.3.1. computer program. The binding potency of insulin was calculated as IC50 using ALLFIT-Pc v.2.7. computer program. We have shown that there are striking differences in insulin binding kinetics in newborn and old rats, depending on kind of tissue tested. The liver plasma membranes ability for insulin binding, number of high (HAIR) and low (LAIR) affinity insulin receptors, values of the dissociation constants and products of association constants and number of insulin receptors, were almost the same, being not dependent on age of the rats. By contrast, there is less high affinity insulin receptors in skeletal muscle of the old animals. The most dramatic changes in insulin binding occur in the heart where both high and low affinity insulin receptors are greatly affected by aging. Our results indicate that the response of the three tissues tested to hyperglycemia and hyperinsulinemia, observed in the old rats, has not been identical and probably can be accounted for by the different distribution of insulin receptor isoforms in the liver, heart and skeletal muscles as shown recently by Vidal et al.

Aging↗
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↗
PubMed1999

[Radionuclide diagnosis of tricuspid regurgitation as a method of estimating the significance of tricuspid insufficiency with concurrent mitral valve disease].

UNLABELLED: A mitral valve replacement without simultaneous correction of a concomitant tricuspid regurgitation aggravates remote postoperative results. Nowadays diagnostics of a degree of tricuspid regurgitation bases on semi-quantitative methods, which are not unequivocal criteria of a significant tricuspid insufficiency. The aim of the study was to investigate diagnostic usefulness of a radioisotopic method of determination significant tricuspid insufficiency. The study group consisted of 35 patients with rheumatic mitral valve disease and tricuspid regurgitation (30 females, 5 males) at a mean age of 55 years qualified for operative treatment. Physical and noninvasive examinations were performed in all patients: chest X-ray (relative heart volume--RHV) and echocardiographicy (tricuspid regurgitation and right ventricle pressure). Final determination of a significant tricuspid insufficiency based on intraoperative diagnosis. The radioisotopic method relies on first pass technique with a determination of a tricuspid regurgitation index (TRI) and a right ventricular ejection fraction. Intraoperatively the patients were divided into two groups: with significant tricuspid regurgitation--21 patients and without--14 patients. Statistically significant differences, considering clinical and echocardiographic assessment between the two groups were noticed. The TRI index did not differentiate two groups. Noninvasive parameters that could affect diagnosis of significant tricuspid regurgitation were proved by a logistic regression analysis. Among them the TRI Index could have a separate value. CONCLUSIONS: Presented radioisotopic method of determination a degree of tricuspid regurgitation with the new TRI Index is of value in diagnosing significant tricuspid insufficiency when assessed with other noninvasive parameters. Estimation of a clinical usefulness of the method needs further investigation and bigger study group.

Adult↗
PubMed1999

[The level of erythropoietin in serum of patients with anemia during infective endocarditis].

The infective endocarditis is a septic syndrome caused by an infection in endocardium or in heart valves. The majority of patients with infective endocarditis develop normocytic anemia. The metabolic studies in septic shock syndromes documented an intensive proteolysis of muscles, visceral organs and blood proteins, and probably of erythropoietin as a glycoprotein as well. The aim of the study was to assess the erythropoietin level in patients with infective endocarditis severe anemia and preserved renal function. Erythropoietin concentration was measured in blood serum in 12 patients (11 men and 1 woman), mean age 48 +/- 8 years, with infective endocarditis. The patients had clinical symptoms of endocarditis, positive blood bacteriological cultures and echocardiography features. All patients had serious normocytic anemia with mean hemoglobin concentration 5.40 +/- 0.48 mmol/L. The control group consisted of 7 healthy persons (5 men and 2 women), mean age 50 +/- 7 years, with hemoglobin concentration 8.70 +/- 0.60 mmol/L. The concentration of erythropoietin at the patients with bacterial endocarditis was 144.04 +/- 17.80 mIU/mL versus 67.28 +/- 6.29 mIU/mL in the control group (p = 0.0002). We conclude that in patients with infective endocarditis and serious normocytic anemia without renal insufficiency the concentration of erythropoietin is increased.

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↗
PubMed1994

Mitral and aortic valve replacement in a patient with ectodermal anhydrotic dysplasia. A case report.

Ectodermal anhydrotic dysplasia is a rare, usually X-linked recessive malformation of ectodermal tissues and organs. The case of a 17-year-old boy with ectodermal anhydrotic dysplasia and concomitant combined mitral valve disease and aortic insufficiency is described. The surgical risk was considered to be high due to severe atrophia of the laryngo-pharyngeal mucosa complicating endotracheal intubation and the possibility of postoperative temperature control disturbances. Double valve replacement was performed late in the autumn, after laryngo-pharyngeal pharmacological treatment preparing for endotracheal intubation. The peri-operative course was managed without any complication related to the hereditary malformation. Our experience suggests that patients suffering from ectodermal anhydrotic dysplasia may undergo open heart surgery after appropriate preparation. Potential postoperative problems related to the hypohydrosis and impaired spontaneous temperature control could be prevented in our patient.

Adolescent↗
PubMed1993

[Concurrent coronary artery disease and acquired rheumatic mitral valve disease].

The aim of this study was to estimate coincidence of coronary artery disease (CAD) and rheumatic mitral valve disease in 264 patients treated in the National Institute of Cardiology (1976-1990). Severity of stenoses on coronary angiography with respect to age, sex, symptoms and risk factors were also estimated. Stenoses over 70% of artery lumen in relation to artery diameter before lesion and over 50% for left main coronary artery were stated as severe. There were 180 (68%) females and 84 (32%) males in the studied group; mean age was 52.5 year. Patients were divided into two groups: with angina--126 pts and without CAD symptoms--138 pts. 8 females (4%) had severe stenoses and 45 (25%) non-severe. Respectively 14 males (16.7%) had severe stenoses and 14 non-severe. Severe lesions were present in a group of females older than 50 years and in a group of males older than 45 years. Both in group with or without angina prevalence of coronary artery lesions was similar. Sensitivity and specificity of CAD clinical symptoms was low (less than 50%). Significantly more risk factors were present in pts with coronary stenoses than in pts free of CAD. No correlation between high pulmonary artery pressure and angina in patients without coronary stenoses occurred.

Coronary Angiography↗
PubMed1993

[Atrial natriuretic peptide in rheumatic mitral valve disease].

The aim of the study was to analyze atrial natriuretic peptide (ANP) plasma level in patients with rheumatic mitral valve disease in correlation with NYHA functional class and selected hemodynamic parameters based on noninvasive diagnostic procedures. Echocardiographic (2-D, Doppler) and X-ray chest examination were performed to measure left atrium dimension, mitral gradient and relative heart volume (RHV). Control group consisted of 10 healthy subjects. ANP were measured (radioimmunoassay) in 35 patients before valve replacement. Mean values for ANP were significantly elevated in all patients compared to control group (p < 0.001). No significant difference between ANP secretion in pts with sinus rhythm (mean ANP level 25.3 +/- 6.9 pmol/l) and pts with atrial fibrillation (mean ANP level 26.7 +/- 7.6 pmol/l) occurred. Positive correlation between left atrium dimension and ANP level were found (r = 0.964) and also between RHV and ANP level (r = 0.9) and between NYHA class and ANP level (r = 0.63). The conclusion is that ANP secretion is elevated in all patients with heart failure due to mitral valve disease proportional to its stage.

Adult↗