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Biomedical subjects

T Zieliński

Publications and source records attributed to T Zieliński.

At least 19 recordsLinked to original sources

Antioxidant activity of resveratrol in endotoxin-stimulated blood platelets.

Resveratrol (3,4',5-trihydroxystilbene) is a natural molecule with antioxidant action. It is also considered to be a molecule with antiplatelet, anticancer and anti-inflammatory action. The effects of trans-resveratrol on the reactive oxygen species (ROS) generation and thiobarbituric acid-reactive substances (TBARS) in blood platelets induced by endotoxin (lipopolysaccharide, LPS) or thrombin were studied in vitro. The production of superoxide radicals (O2.-) and other reactive oxygen species (H2O2, singlet oxygen, and organic radicals) in the presence of resveratrol was measured by a chemiluminescence method in resting blood platelets and platelets stimulated by LPS (0.3 microg/ 10(8) platelets) or thrombin (2.5 U/10(8) platelets). We have shown that resveratrol (6.25-100 microg/ml) inhibits chemiluminescence and generation of O2.- in blood platelets. It has an inhibitory effect on the production of ROS and TBARS in platelets caused by LPS or thrombin.

Animals↗

[Evaluation of surgical flaps used for creation of an artificial penis in female-male type transsexuals].

In the years 1983-1997, 252 female to male transsexuals were treated in the Department of Plastic Surgery of University Medical School in Łódź. In 209 patients surgical penis construction was performed. The paper presents operative techniques and results of penis construction with the use of four kinds of flaps: a bipedicled abdominal tube flap, a single pedicled infraumblical flap, a pedicled myocutaneous flap with gracilis muscle and a pedicled lateral groin flap. Overall estimation of early results of penis construction with the use of the four methods applied in the Department showed that we obtained good results in 69.8% of operated transsexuals, satisfactory effects in 24.4% of patients and poor outcome in 5.8% of cases. The best results were achieved with the technique involving a lateral groin flap.

Adult↗

[Spirometry parameters of women in various positions of delivery].

UNLABELLED: Position in labour depends mostly on women's preferences, and is chosen instinctively in order to reduce labour pain. Between two different positions: vertical and horizontal, the first of them seems to guarantee more convenient gas exchange in maternal lungs. DESIGN: To prove that the vertical position in labour increase spirometry parameters in comparison with horizontal one. METHODS: Women were divided into two groups according to position in labour and spirometry examination were performed in second period of labour. Group I were composed of 17 women in vertical position whereas group II--19 women in horizontal one. RESULTS: Whole of analysed spirometral parameters had higher values in group I (8.2%-17.1%), but the increase wasn't statistically significant (p < 0.05).

Adult↗

Persistent dissection of carotid artery in patients operated on for type A acute aortic dissection--carotid ultrasound follow-up.

Over a period of 5 years, 124 patients were operated on at the National Institute of Cardiology in Warsaw for acute aortic dissection, 27 of whom died. The 97 patients discharged from the hospital were included in the present analysis. The age of the patients ranged from 25 to 73 years with a mean of 50+/-10 years. Ultrasound examination of carotid arteries was performed with the patient lying on his back using a Toshiba 340A color Doppler system with a linear array probe of 7.5 MHz. Of the 97 patients examined, 15 (15%) had a dissection of at least one of the common carotid arteries (CCA). Two had Marfan syndrome. In 11 patients the dissection involved the right common carotid artery and in four it involved both the left and right common carotid arteries. The flow in the true lumen of CCA and ICA was preserved in all patients and the degree of narrowing ranged from 30 to -70%. Only one of the 15 patients with CCA dissection had an ipsilateral neurological deficit which was already present before the aortic aneurysm operation. Ultrasound follow-up was performed in all patients with the CCA dissection found on first examination. The mean duration of follow-up was 21 months. In 14 patients the degree and extent of the dissection as well as the narrowing of the true lumen was comparable, and in one patient the false channel closed spontaneously. During follow-up there were no new major neurological events despite the persistence of the CCA dissection with different degrees of narrowing of the true lumen. Doppler ultrasound examination of the carotid arteries can supply additional information about the extent of the dissection, and help to assess the flow in the persisting 'double channel' common carotid artery during the follow-up of patients.

Acute Disease↗

[Surgical treatment of partial defects of the nose].

During the last 15 years (1981-1995) 70 patients (38 male and 32 female) with partial defects of the nose were treated in the Department of Plastic Surgery of the Medical University of Lódź. In 26 cases there were posttraumatic defects and in 44 patients the defects were secondary to removal of a neoplasm. Patients were divided into two groups. In the first one there were patients with loss of the skin and subcutaneous tissue of a part of the nose; in the second group there were full-thickness defects of the alar base and/or alar rim and columella. Type of surgical reconstruction of the partial defects of the nose depends on location, size and deepness of the defect as well as on the patient's age. The goal of a surgeon who performs the reconstruction is to choose the most simple method with the lowest risk of complications and the method of the best possible esthetic and functional effect. The authors analyze the results of reconstruction of partial defects of the nose with the application of different methods. In 25 patients reconstruction was performed with the use of the pedicled nosolabial transposition flaps, while in other 17 cases composite grafts from auricle were made. Pedicled flaps from the forehead were used in 18 patients, tubed flaps in 3 and retroauricular flaps in 2 individuals. In one case replantation of the nose tissues was performed.

Female↗

Phalloplasty using a lateral groin flap in female-to-male transsexuals.

The paper presents a one-stage procedure for neophallus construction using a lateral groin flap. In the years 1991-1997, 127 female-to-male transsexuals underwent surgery in the Department of Plastic Surgery of the Medical University of Lódź using this method. Good results were obtained in 96 patients (75.6%). Necrosis of the distal part of the flap or other complications that adversely affected the final results of the treatment occurred in 20 cases (20.5%). In 5 cases the flap was completely lost. Phalloplasty along with urethra was done in 5 female-to-male transsexuals. In 47 patients the constructed penis was stiffened with the use of three types of prostheses.

Adult↗

A randomized crossover trial of levodopa in congestive heart failure.

BACKGROUND: The short- and long-term effects of levodopa (L-dopa), an oral dopaminergic prodrug, were assessed in patients with severe left ventricular dysfunction. METHODS AND RESULTS: Initially, 26 patients were included in the study group. After clinical, radiographic, and radionuclide examination, each patient underwent right heart catheterization (Swan-Ganz thermodilution catheter). Plasma noradrenaline levels were measured. In two patients, a favorable hemodynamic response to L-dopa was not observed, another two required permanent pacemaker implantation. These four patients were excluded from the study. Two patients required permanent pacemaker implantation. The remaining 22 patients with favorable hemodynamic response to L-dopa (increase in cardiac index, stroke volume index, reduction in total systemic resistance) were randomized in a nonblinded fashion to the conventional (11 patients) or conventional plus L-dopa (11 patients) treatment groups. During the study period, two patients, one from each group, died. They were excluded from the analysis. The final analyzed study group consisted of 20 men, aged 33-69, in New York Heart Association functional class IV (9 patients) and III (11 patients). The cause of congestive heart failure was primary dilated cardiomyopathy in 11 patients and ischemic heart disease in 9 patients. After 3 months' treatment, all patients were crossed over. Clinical, radiographic, radionuclide, and hemodynamic evaluation was repeated at the end of the 3-month treatment period. After 3 months of therapy with L-dopa in each group (covariance analysis), there was improvement in clinical, radiographic (relative heart volume, -128 mL/m2), radionuclide (left ventricular ejection fraction, +4.6; right ventricular ejection fraction, +4.8%), hemodynamic (mean pulmonary wedge pressure, -8 mmHg; total systemic resistance, -1.8 Wu; total pulmonary resistance, -3.5 Wu), and neurohumoral (noradrenaline, -218 pg/mL) measures. CONCLUSIONS: The addition of L-dopa to conventional therapy has beneficial short- and long-term effects in patients with severe left ventricular dysfunction.

Administration, Oral↗

Prognostic significance of changes in the compliance of the pulmonary venous system after isosorbiddinitrate in patients with mitral stenosis.

It is agreed that a stiff pulmonary venous bed can cause severe pulmonary hypertension. This condition can also influence the clinical and hemodynamic outcome of mitral valve replacement (MVR). This study has been aimed at assessing whether changes in the pulmonary venous compliance (PVcomp) after application of isosorbiddinitrate (ISDN) can be of prognostic value in patients 6 months after MVR. PVcomp was calculated according to the Hirakawa equation in 34 patients with isolated mitral stenosis (MS) before and after ISDN. In 19 patients (group I) there was an increase of PVcomp by more than 15% (5.3 vs. 8.1 ml/mmHg), while 15 patients (group II) showed no differences in PVcomp after ISDN, despite the significant decrease in PAP and PWP in both groups (measured with the use of Swan-Ganz thermodilution catheters). Six months after MVR a significant decrease in PAP, PWP, PVR and an increase in SVI was observed in both groups during rest. During effort (25 W), significant increases in PAP and PWP were recorded in most of patients from the group II, as opposed to group I. It is concluded that significant increase in PVcomp after ISDN in patients with MS can be a prognostic of good clinical results 6 months after MVR.

Adult↗

[Evaluation of changes in pulmonary vein compliance in prognosis of clinical results after mitral valve replacement].

Irreversible decrease in pulmonary venous compliance (PVcomp) can influence on the clinical results of mitral valve replacement (MVR). The study has been aimed at assessing whether changes in the PVcomp after the application of isosorbiddinitrate (ISDN) can be of prognostic significance in pts with mitral stenosis (MS). Right heart catheterization was performed with 34 pts with MS using a Swan-Ganz catheter in supine position, before and after the application of ISDN. Pulmonary artery pressure (PAP), pulmonary wedge pressure (PWP), stroke volume index (SVI), pulmonary vascular resistance (PVR) and heart rate (HR) were calculated according to standard formulas: PVcomp was calculated according to Hirakawa equation. The whole group was divided into 2 subgroups: I--increase of PVcomp after ISDN > 15% (19 pts), II--decrease or no change of PVcomp after ISDN (15 pts). ISDN increased PVcomp from 5.27 to 8.08. ml/m3 in group I, and decrease from 6.74 to 6.31 ml/m3 in group II. There were no differences between both groups during rest and effort before MVR. Six months after MVR decrease in PAP, PWP, PVR and increase in SVI was observed in both groups, but more significant in group I. However during effort (25 W), significant increases in PAP (21.9 vv 36.5 mmHg), PWP (12.9 vs 24.5 mmHg) and HR (80 vs 98 beat/min) with no improvement of PVcomp (5.82 vs 5.68 ml/m2) were recorded in most of pts from group II as opposed to group I. As can be concluded, significant increase in PVcomp after ISDN in pts with MS can be a prognostic of good clinical results after MVR.

Cardiac Catheterization↗

[Coexistence of severe aortic insufficiency and systemic lupus erythematosis with antiphospholipid syndrome--case report].

We presented the coexistence of the severe aortic insufficiency and the systemic lupus erythematosus with antiphospholipid syndrome in 33-years old woman. She was qualified for the operation of the prosthesis aortic valve replacement after she was treated with steroids. During the operation, the heart infarct of the inferior wall had been observed, but finally in the postoperation period the heart efficiency improvement was observed. We have discussed same theories and clinical experiences of lupus erythematosus with antiphospholipid syndrome and clinical sequels.

Adult↗

Pulmonary hemodynamics at rest and effort, 6 and 12 months after mitral valve replacement: a slow regression of effort pulmonary hypertension.

An analysis of pulmonary hemodynamics in 22 patients with postrheumatic mitral valve disease using a floating Swan-Ganz type catheter at rest and effort in supine cycloergometer test was done before, 6 and 12 months after mitral valve replacement. Pulmonary hemodynamics data were recorded and calculated at rest and during effort. The most significant changes in almost all analyzed parameters occurred between preoperative and 6 month examination values. However further modest changes mainly during effort were observed between the 6-month and 1-year follow-ups. The mean workload during the bicycle ergometer test rose significantly from 22 +/- 26 W before to 48 +/- 20 W at 6 months and 57 +/- 22 W at 12 months after mitral valve replacement (P < 0.005). We noted a significant improvement in functional class 6 months after mitral valve replacement and a further slight improvement 12 months after. There was a small statistically insignificant decrease in systolic pulmonary pressure between 6 and 12 month measurements. Systolic pulmonary pressure at rest dropped slightly from 39.0 +/- 9.4 to 34.6 +/- 9.4 mmHg. During the bicycle test after 3 min (25 W) the decrease of systolic pulmonary pressure between the 6- and 12-month measurements was statistically significant. Systolic pulmonary artery pressure dropped from 61 +/- 12.4 to 50 +/- 12.3 mmHg. At the same time the drop in pulmonary wedge pressure was smaller and statistically not significant. Pulmonary wedge pressure at rest 6 months after mitral valve replacement was 14.3 +/- 6 mmHg, and after 12 months was 12.7 +/- 4.5; at 25 W, 24.6 +/- 6 vs. 22.1 +/- 5.5, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Catheterization, Swan-Ganz↗

[Effect of isosorbide dinitrate on pulmonary venous compliance].

Irreversible poor pulmonary venous compliance (PV comp) could worsened natural course of patients (pts) with high pulmonary capillary wedge pressure especially pts with mitral stenosis. Nitrates (isosorbide dinitrate-ISDN) possessing venous dilating action could increase PV comp in most of pts. The main aim of that study was to assess hemodynamic effects of ISDN, in pts with MS, with special emphasis on PV com changes. PV comp was estimated according to Hirakawa equation (dV/dp = 0.4*k2*SV/(v-d) in 35 pts with MS, during preoperative right heart catheterisation with VYGON 5155-180 thermodilution catheters during rest and effort in supine position (25W). The same protocol was performed after Iso-Mack sprawy 3.75 mg. According to the PV comp response to ISDN, pts were divided in two groups: good responders (I)-15% and higher increase in PV comp and poor responders (II). ISDN increased PV comp in the whole group according to the response to ISDN, there were significant differences in stroke volume index (SVI) and heart rate (HR). In the group of good responders mean right atrial pressure (RA), mean pulmonary artery pressure (PAP), mean pulmonary wedge pressure (PWP) decreased significantly with simultaneous slight not significant decrease in SVI and not significant increase of HR. In the group of poor responders SVI decreased significantly by about 20% with significant increase of HR. In conclusion significant decrease in pulmonary pressures (PAP, PWP) in pts with good response to ISDN are secondary to the increase of PV comp, while among poor responders the same effects are due to diminished flow secondary to the decrease of the systemic venous return.

Adult↗

[Effect of improper pulmonary venous compliance on clinical results of mitral valve replacement].

The pulmonary venous vascular volume and its compliance (PVcomp) are important factors influencing filling of the left ventricle. It seems that a poor PVcomp effects the value and reversibility of secondary pulmonary hypertension. Basing on Hirakawa's method PVcomp (= 0.4'' x SV/V-d) was calculated in 34 patients with isolated mitral stenosis (SM). Basing on the mean value of PVcomp the group was divided into those with poor (< = 4.3 ml/mmHg) and good (4.4 and more ml/mmHg) PVcomp. Prior mitral valve replacement (MVR) the groups did not differ in values of PAP, PWP, SVI, PVR assessed at rest. During exercise (25 Watt) in the supine position significant higher values of PAP and PWP were observed in patients with poor compliance. Six months after MVR the PAP and PWP values normalized in all patients. In the patients with the initial good PVcomp values significantly higher values of SVI and a decrease in PVR was found. During exercise (25 Watts) significantly higher values of PAP and PVR were registered in patients with initial poor PVcomp values. Pulmonary venous compliance may be an independent factors influencing the clinical outcome of mitral valve replacement 6 months after the procedure.

Compliance↗

[Pulmonary venous compliance. Indirect evaluation based on pulmonary capillary pressure registration].

The compliance of pulmonary venous system (PV comp) is one of the most important factors influencing left ventricular filling pressure. The decrease of PV comp could be also one of the most important factors promoting secondary pulmonary hypertension. The aim of the study was to assess diagnostic value of PV comp based on some haemodynamic data in patients (pts) with isolated mitral stenosis (MS). PV comp was estimated according to Hirakawa equation (dV/dP = 0.4 * k2 x SV/(v - d), where k2 = 0.075 * PWP + 0.9) in 78 pts with MS, during preoperative right heart catheterisation with Vygon 5155-180 thermodilution catheters. The mean PV comp for the entire group of pts was 4.5 +/- 2.4 ml/mmHg. In pts with atrial fibrillation PV comp was significantly lower as compared with pts on sinus rhythm (3.7 +/- 1.9 vs 6.4 +/- 2.3, p < 0.0001. There was also a significant difference between NYHA I/II vs III/IV class as far as PV comp was concerned (5.1 +/- 2.3 vs 3.9 +/- 2.3, (p < 0.05). In the group with low PV comp less than 4 ml/mmHg pulmonary vascular resistance, RA, PA and amplitude of V-wave of PWP were significantly higher and stroke volume index of RV was lower than in the group with PV comp above 4 ml/mmHg. PWP did not differentiate the analysed groups. A decrease of PV comp is a sign of advanced mitral stenosis.

Atrial Fibrillation↗

[Surgical treatment for mitral valve defects with preponderance of mitral stenosis and high pulmonary vascular resistance. Clinical and hemodynamic observations 6 months after valve replacement].

10 patients with isolated or predominant mitral stenosis (mean mitral valve area 0.9 cm) and high preoperative values of pulmonary vascular resistance (mean 7.2 Wood units) were chosen for further hemodynamic postoperation evaluation. The patients had normal function of the aortic valve and no significant stenosis of coronary arteries. Hemodynamic evaluation was done by floating Swan-Ganz catheter preoperatively at rest and 6 months after mitral valve replacement at rest and during bicycle cycloergometer test in the supine position. Significant improvement in NYHA class was noted. Preoperatively 6 patients were in NYHA III class, 4 in NYHA IV class. After mitral valve replacement 4 patients were in class III and 6 in class II. Before mitral valve replacement only 3 patients were able to perform 25 Watt test. After surgery all except one performed at least 25 W. There was a significant decrease of pulmonary vascular resistance from 7.2 +/- 2.2 preoperatively to 3.1 +/- 1.9 Wood units at rest after the operation. Post operation during exercise pulmonary vascular resistance attained 4.2 +/- 1.9 Wood units. These changes were due to a fall in mean pulmonary artery pressure 49 +/- 13 at rest preoperatively to 25 +/- 6 mm Hg (rest) and 43 +/- 14 mm Hg (23 W) postoperatively and a rise in stroke volume index from 24 +/- 7 ml (m2) beat preoperatively to 32 +/- 9 at rest and 33 +/- 6 (25 W) postoperatively. Despite clinical and hemodynamic improvement there was no full recovery of pulmonary hemodynamics.

Adult↗

[Hemodynamic effects of one administration of l-dopa in patients with left ventricular heart failure (introductory remarks)].

The study group consisted of 8 men with congestive heart failure. They ranged in age from 33 do 63 years (mean 48). Three patients were in class III NYHA, five in class IV. Idiopathic cardiomyopathy was diagnosed in 6 patients, one individual displayed ischemic heart disease and one patient was after mitral and aortic-valve replacement despite a normally functioning prosthetic valve. L-dopa was given orally beginning with 250 mg every six hours until a total daily dose of 4.0 g was achieved with no side effects (patients additionally received 50 mg of pyridoxine hydrochloride). Afterwards L-dopa was withheld for 24-36 hours. Having completed this washout period, patients underwent right heart catheterization, with placement of a balloon-tipped thermodilution catheter in a pulmonary artery, so that balloon inflation allowed recording of the pulmonary capillary wedge pressure. Right atrial and pulmonary arterial pressures were monitored continuously. Systemic arterial pressure was measured by mercury manometer. Cardiac output was determined by the thermodilution technique. Rest and effort hemodynamic measurements were repeated before and one, three hours after administration of 1-dopa. The base-line hemodynamic values were consistent with the clinical presentation of severe congestive heart failure. The average cardiac index (CI-1/min/m2--rest--1.93; 25 Watt-3.1) and stroke volume index (SVI-m1/m2--rest--22.2; 25 Watt-32.0) were markedly lowered. Left ventricular filling pressure and pulmonary artery pressure were elevated. The systemic vascular resistance was significantly increased (SVR -j.W.--rest--22.7; 25 Watt-14.2). Administration of 1-dopa resulted in the increase in cardiac index and stroke volume index accompanied by a substantial reduction in systemic vascular resistance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Factors influencing survival in patients with coronary disease. I. Characteristics of examined patients and survival curves].

The group of 683 patients with the significant narrowing (> 70%) of at least one coronary vessel diagnosed by coronarography performed between 1976-1988 in the Institute of Cardiology in Warsaw was followed during one to seven years. The number of patients with a poor left ventricular function was high in the group treated surgically and non surgically. Ejection fraction < 50% was found in 27% and 43% respectively, LVEDP > 12 mmHg (66% and 69%), EDVI > 100 ml/m2 (58% and 70%). Survival curves were calculated in the two different subsets of patients treated surgically and non surgically. Despite some favorite trend toward a better outcome for patients treated surgically the differences were not statistically significant for a whole group. However we showed a significantly higher probability of survival in the subgroup of the three vessel disease treated surgically compared to other treatment. There were no significant differences in survival in patients with one, two, or three vessel disease treated surgically (survival probability of 0.82; 0.78; 0.84 respectively after 7 years). In patients treated non surgically the growing number of diseased vessels worsened the prognosis (survival probability of 0.84; 0.78; 056 respectively). In our observation the differences for better outcome in patients with poor left ventricular function treated surgically did not reach a statistical significance.

Coronary Angiography↗