Biomedical subjects

W Lechowicz

Publications and source records attributed to W Lechowicz.

36 records · Page 2Linked to original sources

PubMed1997

Basic analytical parameters as the predictive factors for 30-day case fatality rate in stroke.

In a prospective population-based study, analyses were performed to evaluate the 30-day case fatality in stroke as related to the following factors: hematocrit (HCT), hemoglobin (Hgb), red blood cells (RBC), mean cell volume (MCV), platelet count, erythrocyte sedimentation rate (ESR), white blood cells (WBC) and glucose concentration. We studied 345 patients with stroke, 170 men and 175 women, mean age 68.4 +/- 14.2 years, admitted within 72 h of stroke onset. Patients who died had significantly higher mean values of ESR, WBC, HCT and glucose concentration than the patients who survived. Logistic regression analysis revealed that ESR, HCT and WBC are independent factors predicting 30-day case fatality. The odds ratio (OR) for ESR was 1.006 (95% CI 1.0002-1.011), for HCT 1.04 (95% CI 1.01-1.07), for WBC 1.03 (95% CI 1.01-1.05). Glucose concentration after adjusting for the severity of neural deficit did not become an independent predictor.

Age Factors↗

PubMed1997

Stroke mortality rates in Poland did not decline between 1984 and 1992.

BACKGROUND AND PURPOSE: Stroke mortality has decreased in most industrialized countries in recent decades. In Poland, as in other eastern European countries, mortality rates for stroke remain high. METHODS: The Warsaw Stroke Registry (WSR) registered patients in the Mokotów district of Warsaw from 1991 through 1992. The Warsaw Pol-MONICA study registered stroke patients in the North and South Praga regions of Warsaw from 1984 through 1992. Stroke incidence rates, case-fatality rates, and stroke mortality rates were computed based on both studies and compared with published mortality rates based on death certificates. Eight-year trends of stroke incidence, case-fatality rate, and mortality were derived from the Warsaw Pol-MONICA study. RESULTS: The WSR and Warsaw Pol-MONICA studies showed similar incidence rates, mortality rates, and 28-day case-fatality rates for stroke. Mortality rates from the WSR and the Warsaw Pol-MONICA study were similar to rates from death certificate data. Mortality rates in the group aged 35 to 64 years were higher in men (47.5 to 50/100000 per year) than in women (30/100000 per year). CONCLUSIONS: Two different population-based studies suggest that stroke mortality is high in Poland because of high 28-day case-fatality rates. Stroke mortality failed to decline in Poland in the period 1984 through 1992 because neither case fatality nor stroke incidence declined in this period.

Adult↗

PubMed1997

A morphometric evaluation of morphological types of microglia and astroglia in human fetal mesencephalon.

Quantitative changes associated with the differentiation of microglial and astroglial cells in 48 fetal mesencephalons between 8 and 22 week of gestation (GW) were studies. Using lectin (RCA-1) labelling, two morphological types of RCA-1 positive cells, ameboid microglia (AM) and ramified microglia (RM) were identified on the basis of the cell body shape and the configuration of cytoplasmic processes. Astrocytes (AS) were identified by immunocytochemical labelling of GFAP. Measurements of microglial and astroglial cells were carried out in mesencephalon tectum and tegmentum under the microscope in sequential segments corresponding to equal sized non-overlapping areas. The quantitative data about concerning the number and percentage distribution of AM, RM and AS from each of the grid-quartiles were analyzed. The study revealed a time-sequence of appearance, characteristic pattern of distribution along perpendicular and longitudinal axes originating from aqueduct and changes in percent distribution of both types of microglial cells and astrocytes. Ameboid type of microglia was already present in 8 GW fetus in tectum (22.5 cells/mm2) and in tegmentum (10.2 cells/mm2). During the fetal development the number of AM peaked about 8-9 GW in tectum, accounting for 29 cells/mm2 close to aqueduct, and about 11-12 weeks in tegmentum, reaching 10.2-11 cells/mm2 close to aqueduct. As the fetus development advanced, the number of AM cells both in tectum and tegmentum was slowly dropped down reaching about 1.0 cells/mm2 in 20-22 GW. The ramified microglial cells as well as astroglial cells emerged in the fetal mesencephalon after 11 GW. A quantitative study also revealed a rapid increase in the density of RM in 13-16 GW (6.3 cells/mm2-close to aqueduct) and AS cells in 13-16 GW (36 cells/mm2-close to aqueduct) and later a decrease in cell number was observed. Similarly to AM, changes in the number of RM and AS cells were stabilized to about 20-22 GW. The percentage distribution of each type of microglia and astrocyte cells both in tectum and tegmentum differed markedly during the fetus development depending on the localization along the axes.

Astrocytes↗

PubMed1997

Qualitative and quantitative analysis of locus coeruleus neurons in Parkinson's disease.

The analysis of qualitative changes in the locus coeruleus (LC) was performed on brains from 21 cases of Parkinson's disease. Eleven cases were selected for quantitative analysis of the loss of LC noradrenergic pigmented neurons. The qualitative studies revealed uneven dissemination of the noradrenergic cells loss of overall structure of the LC. Few preserved neurons showed degenerative changes. Extracellular neuromelanine granules, traces of dying neurons, were also observed. A weak astro- and microglia proliferation corresponded with neuronal loss. Lewy bodies were found in the LC in all cases. The quantitative analysis revealed that the average loss of adrenergic neurons in the LC accounts for about 70% in relation to the control group. The degenerative changes were observed in the whole LC, but they were most intensive in its caudal and next in the middle segment. The results suggest also that the degenerative process began in the middle segment and then it spread towards caudal segment of the LC as the stages of disease advanced.

Aged↗

PubMed1997

Quantitative study of pathological forms of astroglia in Wilson's disease.

The number and distribution of Alzheimer type I and II cells (Alz I and II) as well as Opalski cells (Opl) were estimated in chosen brain regions of seven autopsied cases with Wilson's disease (WD). The authors of this study focused especially on the question whether the kind and intensity of astrocytes is linked to the clinical form of the disease and to the intensity of brain damage. Alz I and II cells were counted by the use of the HE method, whereas the number of Opl cells was calculated using the PAS method. The study revealed that among the three types of cells the number of Alz II cells was the highest and that of Alz I cells was the lowest. The distributional patterns of these three types of cells were different. Alz I cells were found mainly in the putamen. Alz II cells were observed diffusely, although they occurred in different numbers in the whole brain. The highest number of Opl cells was found in the putamen. Alz I cells were found only in the neurological type of the disease. The highest number of Alz II cells was seen in the hepatic type of the disease, whereas the highest number of Opl cells was observed in the neurological "mixed" forms. Moreover, intensity of tissue damage with presence of necroses was greatest in neurological WD. In the hepatic type dispersed areas of status spongiosus were observed, without presence of necroses. Our study revealed that the type and amount of the pathological astroglia may correlate both with the clinical form of WD and intensity of tissue damage. Alz II cells seem to be a characteristic feature of the early stage of astroglial response to the pathogenic factor whereas Alz I and Opl cells occur in WD only in the advanced stage of tissue damage.

Adolescent↗

PubMed1996

Changes in dopaminergic neurons of the mesocorticolimbic system in Parkinson's disease.

The qualitative analysis of changes in major nuclei (n. paranigralis left and right, n. interfascicularis) of the mesocorticolimbic system (ventral tegmental area-VTA) was carried out on 25 cases with Parkinson's disease (PD). The cellular depletion with insignificant gliosis without the presence of macrophages was found. In addition, numerous extracellular melanin nodules being the remnants of broken dopaminergic neurons were found. The presence of Lewy bodies observed in all cases confirms the diagnosis of idiopathic Parkinson's disease. The morphometric analysis performed on selected long-lasting 7 PD cases and 6 controls showed that cellular depletion in n. paranigralis and in n. interfascicularis accounts for 42% and 62%, respectively in relation to controls. The number of melanin nodules grows with the age in the control group. While in the group of PD cases the number of nodules in VTA declines with the disease duration. It may indicate that the factor which damages melanin neurons also exerts a destructive effect on extracellular melanin.

Age Factors↗

PubMed1996

Evaluation of survival and maturation of cryopreserved dopaminergic fetal cells transplanted into rat striatum and an analysis of the host brain reaction to graft.

A fetal, cryopreserved ventral mesencephalic rat tissue was transplanted into striatum of healthy adult rats. A stereotactic apparatus was used for transplantation of solid tissue blocks. The survival of transplanted dopaminergic cells in rat striatum was evaluated by means of histological and immunocytochemical methods (TH - thyrosine hydrolase) 1, 3, 7, 14, and 21 days after transplantation. The cellular reaction of the host to graft and to sham-lesion was examined. Glial fibrillary acidic protein (GFAP) was used for the visualization of astroglial reaction and ferritin for microglia. It was found that fetal cells of cryopreserved rat ventral mesencephalon transplanted into adult rat striatum survive though, in a small number. Cellular reactions of the host to both graft of dopaminergic cells and sham-lesion are similar to glial scar and are nonspecific.

Animals↗

PubMed1996

Adult schizophrenic-like variant of adrenoleukodystrophy.

A 35-year-old man died after 30 months following the onset of the disease. There was a history of changes in his mental condition, including disturbances of behavior as well as the evidence of progressing dementia. The patient revealed gait disturbances and finally became bed ridden. Bizarre behavior and changes of mood with concurrent growing irritability which predominated during the course of disease, may explain the initial diagnosis of schizophrenia. Then cerebellar and spastic movement disorders leading to paraparesis and sphincters disturbances developed. Clinical symptoms of adrenal failure were not found apart from episodes of arterial pressure fall. After two years a magnetic resonance imaging (MRI) revealed an extensive diffuse demyelinative process in white matter of cerebral and cerebellar hemispheres. Activity of lysosomal enzymes was normal. A general autopsy revealed atrophy of adrenal cortex and the presence of ballooned cells with striated cytoplasm in the reticular and fasciculate zones. Neuropathological examination revealed an extensive demyelination of white matter in cerebral and cerebellar hemispheres and of the long paths of the brain stem, corresponding to changes in MRI examination. Within demyelination areas damage of axons and diffuse cellular and fibrous gliosis were found as well as perivascular lymphocytic infiltrations with the presence of strong PAS (+) and Sudan (+) macrophages. Immunocytochemical reactions with HAM-56 and RCA1 in macrophages were positive. Electron microscopy examination revealed lamellar inclusions in cytoplasm of macrophages. Similar structures were present in the lysosomes of astrocytes. Morphological examination of adrenal glands as well as morphological and ultrastructural study of the brain allowed us to diagnose the cerebral form of adrenoleukodystrophy (ALD). Topography and character of the brain changes seems to be in keeping with a rare schizophrenic-like variant of ALD with progressive dementia. Abnormal plasma profile and increased VLCFA concentration in the patient's 13-year-old daughter confirm the ALD diagnosis.

Adrenoleukodystrophy↗

PubMed1994

[The application of graphic (visual) databases in neurology and neuropathology].

The possibilities and principles of creation in Windows environment of visual databases are described which could be used for elaboration of multimedial encyclopedia of selected nosological entities. Such databases are particularly important in education making possible finding of data and their relative comparison. The method of organization of "files" using standard programmes of Windows packs and the method of application of the technique of image coding for forms of symbolic icons are presented. Examples of graphic bases of neurological and neuropathological data evolved in Windows environment using professional application programmes (framing and retouching of images in graphic editors, coding of icons of macroinstruction of reading of information introduced into the relating visual database of the analysed cases.

Brain Diseases↗

PubMedDate not supplied

[A sporadic case of Creutzfeldt-Jakob disease with peculiar neuropathological lesions].

The authors report a case of Creutzfeldt-Jakob disease in a man aged 60 years from a family without a history of similar disease. The disease extended over 11 months. In the clinical picture initially equilibrium disturbances and dementia with psychotic symptoms predominated, EEG pattern was not typical of CJD. Neuropathological examination revealed extensive spongiform lesions in the cortex of all cerebral lobes, in striatum and substantia nigra, moreover a considerable number of kuru plaques was found in cerebellar cortex. The authors consider that the case meets the criteria accepted for the sporadic form of CJD but believe that the final differentiation from the Gerstmann-Streussler-Scheinker syndrome should be based on genetic studies.

Cerebellum↗

PubMedDate not supplied

[The use of gammaglobulin for preventing infection in stroke].

In the study the influence of giving gammaglobulin on the course of stroke was tested. The trial was double blind, with a control group and with a randomised administering of gammaglobulin and placebo. The condition for including a patient in the trial was clinical diagnosis of stroke, period of time from the onset not longer than five days, and the absence of both clinical and laboratory features of infection. 36 patients were given gammaglobulin (Veinoglobulin Institut Merieux) in 10 g doses at 3-day intervals, 35 patients were given placebo: 10g of albumin. The clinical follow-up lasted 30 days. Three patients from the gammaglobulin group and nine patients from the placebo group died. Administration of gammaglobulin decreased the tisc of death by 74%. The improvement of neurological deficit in 30-day survivals in the treated group was more expressed than in the placebo group. The total number of infections, number of days with increased temperature, number and time of given antibiotics were comparable in both groups. The results obtained suggest that prophylactic treatment with gammaglobulin does not prevent infections but their course is milder with consequent better clinical improvement and lower mortality.

Aged↗

PubMedDate not supplied

[Ganglioside GM1 in early strokes].

The study was taken up to compare the effect of treatment with ganglioside GM1 (Sygen, FIDIA-Italy) and typical treatment in the course of the disease. The study included 98 patients aged 40-82 in good or moderately good physical condition, with the ischaemic stroke confirmed by CT scan, in early stage of stroke (within 48 hours after onset). Patients with severe physical diseases were excluded. The patients were divided at random into two groups. Group I (50 patients) was treated typically and group II (48 patients) was given both typical treatment and ganglioside GM1 administered in 100 mg daily doses over 30 days, i.v. during first 5 days, then i.m. The neurological state was assessed according to the Canadian Neurological Scale (CNS), general fitness according to the Ranking Classification of Neurologic Disability Status (RS) at the admission and after 30 days of the treatment. After 30 days of the treatment no difference between the two groups was found in: 1) mortality, 2) mean survival time, 3) neurological state, 4) patient general fitness. According to the above results the beneficial influence of Sygen treatment of ischaemic stroke was not confirmed.

Adult↗

PubMedDate not supplied

[Neurotransplantation. III. Intracerebral grafting of fetal substantia nigra in Parkinson's disease].

The paper reports the results of fetal substantia nigra transplantations into the brain of patients suffering from Parkinson's disease, performed in different neurosurgical centers in the world. Commonly accepted Ethical Guidelines for Fetal Tissue Transplantations are presented. The criteria regarding patients selection for therapeutic transplantation are also discussed. The results of studies concerning the problem of optimal fetal age for transplantations are presented. The optimal age seems to cover the period between the 7th gestational week when dopamine synthesis begins and the 11th week when protoplasmic processes start to grow intensively. The damage of these processes during transplantation procedure is thought to make the fetal cells survival difficult. The discussion concerning controversial problem of immunosuppression treatment after the neurotransplantation is also reported. The paper presents the principles of signs and symptoms assessment before and after operation including CAPIT system which emphasises the role of movement ability tests, PET-scanning with [18F]-6-L-fluorodopa and magnetic resonance imaging. The PET-scanning allows to follow up the changes in patient's brain resulting from the graft survival and its dopamine synthesis ability. The methods of donor woman examination to avoid the transmission of infections into the patient's brain are reviewed. The analysis of yet published results of about 100 operated on parkinsonian patients show marked improvement due to human fetal substantia nigra transplantation. The improvement lasts, at least 46 months postoperatively (the longest period of observation). Many of the grafted patients returned to normal self-dependent living activities and some of them resumed even their professional jobs. Most authors present the opinion that the therapeutic effects of fetal substantia nigra transplantations are more valuable and longer lasting than those after adrenal medulla autografts. However it should be borne in mind that both methods are yet only the experimental approach in Parkinson's disease therapy.

Fetal Tissue Transplantation↗

PubMedDate not supplied

[Risk factors in patients with stroke].

The prevalence of risk factors in relation to age was analysed in 470 patients with ischaemic or haemorrhagic stroke. In all patients the most frequent risk factor was hypertension: 54-72% in haemorrhagic stroke, and 44-49% in ischaemic stroke. Moreover, in both types of stroke in the group aged up to 50 years the proportion of heavy smokers was high: 54% in haemorrhagic and 44% in ischaemic stroke. In the group aged 51 to 65 years coronary disease was present in 44% of haemorrhagic and 41% in ischaemic stroke. In patients aged 65 years coronary disease was present in 59% of haemorrhagic strokes and in 33% of ischaemic strokes. Arrhythmia was noted in 45% of haemorrhagic and 36% of ischaemic strokes. The presence of risk factors had an influence not only on the incidence of strokes but also on their course and prognosis, this was true especially of ischaemic stroke, since in dying patients, especially those aged below 50 years, the prevalence of hypertension, smoking and coronary disease was higher. In patients aged over 65 years mortality was higher in those with arrhythmias and coronary disease.

Adult↗

PubMedDate not supplied

[Morphometric assessment of lesions in the dopaminergic nigrostriatal system in Parkinson disease].

The qualitative changes in substantia nigra were analysed in the material of 25 cases of Parkinson's disease. A morphometric quantitative study of depletion of pigmented dopaminergic cells of substantia nigra was performed in six long-term cases of the disease. In addition, the number of melanin nodules was assessed as a marker of cell disintegration. The results obtained were compared with the morphometric evaluation of neuronal depletion in the mesocorticolimbic system (ventral tegmental area-VTA). The qualitative study indicated that melanin depletion in dopaminergic cells of substantia nigra in Parkinson's disease is diffuse and it is located mainly in the lateral alfa layer. Neuronal depletion with concomitant numerous extracellular neuromelanin nodules and granules was observed. A slight astrocytic gliosis free of macrophages accompanied cellular changes. The qualitative changes in substantia nigra are similar to those observed in VTA. The morphometric evaluation revealed that depletion of dopaminergic neurons in substantia nigra in Parkinson's disease is 73%, on average, while in VTA it remains under 5%. Hence, depletion in substantia nigra is much more intense. The analysis of the relationship between the number of neurons in substantia nigra and the age of subjects in the control group indicated that the number of neurons decreased proportionally to the age. In the group under study no significant relationship between neurons depletion and duration of disease or patients age was found. In the studied group of patients with Parkinson's disease, the number of melanin nodules in substantia nigra was significantly higher than in controls.

Corpus Striatum↗

PubMedDate not supplied

[Current views on the mechanisms of dopaminergic neuron death of the nigrostriatal system in Parkinson's disease].

Current views on the pathogenesis of Parkinson's disease are presented. Studies, particularly those carried out during the last decade, highlight the significance of endogenic processes responsible for a cumulative production of neurotoxic substances, especially free oxygen radicals which exert chronic effect on neurons. In Parkinson's disease, overproduction of free radicals and concomitant failure of protective mechanisms are most likely. An excess of free radicals is cytotoxic because of their very high chemical activity and uncontrolled chain reactions with numerous organic compounds, especially those which are mostly responsible for vital functions of cells. Oxidative stress disturbs metabolism of the cell what finally leads to its death most probably due to damage of cell membrane. That results in increased plasma membrane permeability for calcium ions which activate several subcellular mechanisms and initiate the final phase of cell death. Nonprotein-bound "free" iron ions are the strongest and most dangerous generators of free oxygen radicals. It is thought that ferric (Fe-3+" iron bound to neuromelanin may play a profound role in the overproduction of especially cytotoxic hydroxyl radicals, derivatives of molecular oxygen. Both, oxygen stress inducing factor and the sequence of related biochemical disorders remain still unknown. However, the synergy of the excess of reactive oxygen metabolites (mainly free radicals), nitric oxide, "free" iron ions and neuromelanin may contribute considerably to the generation of oxygen stress.

Brain↗

PubMedDate not supplied

[Carotid artery disease in patients with ischemic stroke. Results of year-long observation conducted within the framework of prospective epidemiological studies, Warsaw, 1991-1992].

A cohort of 297 patients with ischaemic stroke were followed for one year. Doppler ultrasonography, done in 219 patients (109 women and 110 men), aged 68.0 +/- 12.6, revealed a concomitant carotid artery occlusive disease (CAD) in 76 patients (34.7%), 34 women and 42 men, aged 66.5 +/- 11.1, 45 of them had high grade stenosis (> 75%) or occlusion. Claudication, myocardial infarction and hypercholesterolaemia diagnosed before the onset of stroke was found more often in patients with CAD, 11.1%, 22.2% and 4.4% was versus 2.8%, 12.3% and 1.4% in patients without CAD. Prevalence of other stroke risk factors, hypertension, diabetes, angina in both groups of patients was similar. Severe stenosis or occlusion was diagnosed more often among men (58%) and among smokers (55%), in the group of patients without CAD than 48% and 42% respectively. The onset of stroke was preceded more often by TIA--24% in group with CAD, versus 17% in patients without CAD. Neurological state on admission, test by Stroke Severity Scale and Weakness Score according to SDB, was similar in both groups of patients but prognosis was worst among patients with CAD, 13.5% of them developed recurrent stroke versus 7% in group without CAD. In Kaplan-Meier analysis one year cumulative survival rates were lower in the group of the patients with severe stenosis or occlusion.

Aged↗

PubMedDate not supplied

[Modern views on the pathogenesis of Wilson's disease].

Wilson's disease is a rare, multiorganic genetically coded disorder, induced by impaired copper transport. The recent identification of the disease gene and the discovery of gene product--copper transporting P-type ATPase that is integrate membranous protein has contributed greatly to better understanding of the pathogenesis. This protein is probably essential for incorporation of copper into ceruloplasmin and for its biliary excretion. Multiple mutations of Wilson's disease gene are responsible for the excess of so called "free" copper which is toxic to tissues. Copper toxicity involves first of all, functional disorders of many enzymatic systems, particularly those of respiratory chain enzymes. In the central nervous system, a special kind of copper toxicity is medicated by astroglia, so that a direct, harmful effect of both copper and ammonia on the brain is observed. The authors present a current review on biochemical mechanisms of copper toxicity and physiopathological significance of the CNS astroglia in Wilson's disease.

Hepatolenticular Degeneration↗