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Biomedical subjects

Z Sadowski

Publications and source records attributed to Z Sadowski.

At least 127 records · Page 7Linked to original sources

The role of hyperinsulinemia in the development of lipid disturbances in nonobese and obese women with the polycystic ovary syndrome.

In order to establish the role of insulin in the pathogenesis of lipid abnormalities in hyperandrogenic women with the polycystic ovary syndrome (PCO) 49 women aged 18 to 35 yr with a normal glucose tolerance test were studied. They were divided into two groups: 27 women with PCO (9 obese and 18 nonobese), and 22 healthy women (12 with simple obesity and 10 with normal body weight). In the PCO group, the fasting insulin levels and the insulin response to oral glucose load were higher than in the matched controls. Significantly lower levels of HDL2-cholesterol and higher levels of apolipoprotein B were observed in obese and non nonobese PCO patients. In obese women with PCO this was associated with lower levels of HDL-cholesterol and apolipoprotein A-I (Apo A-I), whereas the levels of total triglycerides and VLDL-triglycerides (VLDL-TG) were increased. Multiple regression analysis in PCO women, after adjustment for age, body mass index and the levels of insulin and sex hormones, showed a strong positive correlation between the fasting insulin levels and total triglycerides and VLDL-TG, while a negative correlation was found between fasting insulin levels and apo A-I. These results indicate that hyperinsulinemia may play a role in the development of lipid disturbances in women with the PCO.

Adolescent↗

Transdermal 17 beta-estradiol combined with oral progestogen increases plasma levels of insulin-like growth factor-I in postmenopausal women.

In order to evaluate the effect of postmenopausal estrogen replacement therapy on the plasma levels of the insulin-like growth factor-I (IGF-I) 12 postmenopausal women aged 44 to 59 years were studied. The control group consisted of 15 healthy premenopausal women aged 20-44 years. In the postmenopausal women the plasma levels of IGF-I, gonadotrophins and sex hormones were determined before and after 3 and 6 months cyclic replacement therapy with transdermal 17 beta-estradiol (E2 100 micrograms patches applied twice weekly) combined with oral chlormadinone acetate (2 mg daily for 7 days in each cycle). Basal levels of estradiol (E2), IGF-I, dehydroepiandrosterone sulphate (DHEA-S), testosterone and androstenedione were lower, but gonadotropin levels were higher in postmenopausal than in premenopausal women. In all the women studied age was inversely correlated with IGF-I levels (r = -0.793, p less than 0.001) and with DHEA-S concentrations (r = -0.435, p less than 0.02). In postmenopausal women transdermal estradiol administration restored the circulating E2 levels to the early follicular range and increased the IGF-I levels (from 76.4 +/- 9.2 micrograms/l to 141.8 +/- 20.8 micrograms/l; p less than 0.01). Transdermal estradiol decreased gonadotrophin levels without changes in concentration of DHEA-S, testosterone, androstenedione and SHBG. In postmenopausal women before and during replacement therapy a positive correlation was found between estradiol and IGF-I concentrations (r = -0.439, p less than 0.01). These results suggest that cyclic replacement therapy with transdermal 17 beta-estradiol in combination with chlormadinone acetate given orally increase the plasma levels of IGF-I in postmenopausal women.

Administration, Cutaneous↗

[Spontaneous ventriculostomy developing in non-communicating hydrocephalus of unestablished etiology].

The authors report a case of exceptionally rarely occurring spontaneous ventriculostomy in the region of epiphyseal recess in a patient with increasing non-communicating hydrocephalus. This case is the fourth one diagnosed intravitally in a group of 22 cases published as yet. Positive ventriculography was the method establishing the diagnosis of this condition during life. Restoration of communication in intracranial cerebrospinal pathways with bypassing of the blockade by development of spontaneous ventriculostomy is regarded as a trial of self-treatment of the organism. The observations demonstrated that this bypassing in a group of 22 cases published as yet. Positive ventriculography was the method establishing the diagnosis of this condition during glife. Restoration of comis, in such cases, creation of ventriculo-atrial communication for reduction of intracranial pressure.

Adult↗

What intervals in oral therapy of isosorbide dinitrate in various doses are sufficient to prevent nitrate tolerance?

INTRODUCTIONS: The organic nitrates are effective anti-anginal drugs during initial treatment, but their therapeutic value is compromised by the rapid development of tolerance during sustained therapy. The only widely accepted method of preventing tolerance is the use of intermittent administration, but without specifying to what extent the length of interval is dependent on type and dose of nitrate. The aim of this study was to evaluate how long periods free of nitrates are sufficient to prevent tolerance in long-term therapy with oral sustained-release isosorbide dinitrate (ISDN). MATERIAL AND METHODS: In a double-blind study, 38 patients with stable angina, received ISDN: 40 mg, 80 mg and 120 mg or placebo in the first ingestion (1st) and in long-term therapy in four 7 day phases: 4-times-daily (4x), 3-times-daily (3x) with 12 h nitrate-free interval, twice-daily (2x) with 18 h interval and once-daily (1x). After 1st and on the last day of each long-term phases, exercise tests with the analysis of walking times: total, to angina and to ischaemia (WTI) were performed: preceding ingestion, 2 h and 6 h after. RESULTS: Six hours after 1st all doses WTI improved significantly in comparison to placebo (p < 0.0001): 40 mg by 52.5%, 80 mg by 66.0% and 120 mg by 58.4%. None of the ISDN doses improved significantly WTI in 4x phase; in 3x, only 40 mg by 12.1% (p < 0.05); in 2x, only 80 mg by 22.3% (p < 0.05) and in once-daily, 80 mg by 27.2% and 120 mg by 36.2% (p < 0.01). CONCLUSION: 12 h nitrate-free interval is sufficient in order to prevent tolerance in long-term treatment of sustained-release ISDN with 40 mg dose, 18 h with 80 mg and 24 h with 120 mg doses.

Administration, Oral↗

[Embolization of the branches of the external carotid artery].

Authors present their own experience with the embolization of the external carotid artery branches. The main indications to embolization included well vascularized and hemorrhagic brain tumors in facial part of the skull, mainly meningiomas, juvenile angiofibromas, and angioneuromyomas. Embolization of external carotid artery was performed in 15 patients. Complete impatience of blood vessel supplying the tumor was achieved in 12 cases, but it was incomplete in 3 cases. Single serious complication in the form of hemiplegia was noted. There were also mild complications in 5 patients, which did not require any intervention.

Adolescent↗

Pharmacokinetics of mexiletine and its metabolites, hydroxymethylmexiletine and p-hydroxymexiletine, after single oral administration in healthy subjects.

Pharmacokinetics of mexiletine and its major metabolites, p-hydroxymexiletine and hydroxymethylmexiletine, were studied in 10 healthy subjects after administration of a single oral 400 mg dose. Mexiletine was extensively metabolized to hydroxymethylmexiletine and less to p-hydroxymexiletine. Mean metabolic ratio (Rm) was 0.54 and 0.18 respectively. Peak serum concentrations (Cmax) for mexiletine (0.686 +/- 0.110 micrograms/ml), hydroxymethylmexiletine (0.507 +/- 0.087 micrograms/ml), and p-hydroxymexiletine (0.096 +/- 0.046 micrograms/ml) occurred after 3.0, 4.0 and 4.2 +/- 0.6 h. Disposition parameters for mexiletine were as follows: volume of distribution (V lambda), 5.44 +/- 1.44 l/kg; serum clearance (CL) 8.08 +/- 1.23 ml/min/kg. There were no significant differences in elimination half-life (t1/2) and mean residence time (MRT) for mexiletine and its metabolites. Double-peak phenomenon was observed for all the subjects on elimination phase of mexiletine, hydroxymethylmexiletine and p-hydroxymexiletine.

Administration, Oral↗

[Spasm in angiographic image and the development of the symptoms of ischemic stroke in patients after subarachnoid hemorrhage from supratentorial ruptured aneurysm].

The results of angiographic examinations are presented in relation to the development of ischaemic stroke in 219 patients. In the selection of the patients cases were ruled out with coexistent intracranial haematomas, and the patients treated surgically were ruled out in whom the course of the operation suggested a possible influence of additional factors which might have changed the condition of the patient independently of the main disease. Depending on the results of angiography three groups of patients were isolated with different likelihood of ischaemic stroke development: patients without vasospasm or with segmental vasospasm-stroke developed in 15%-9% of cases; patients with unilateral or bilateral diffuse vasospasm of low or medium intensity-stroke in 34%; patients with high-grade diffuse intensity-stroke in 73% of cases. The frequency of stroke in these groups is analysed in relation to the condition of the patient at the time of angiographic examination.

Adolescent↗

[Sex hormones in men with coronary arteriosclerosis].

Testosterone and estradiol levels were determined in 85 male patients aged between 23 and 52 years with: coronographically diagnosed coronary arteriosclerosis (20 with the instable and 37 with stable coronary disease), and in 28 healthy volunteers serving as a control group. Testosterone concentrations in the instable coronary disease (13.6 +/- 1.7 nM/l) were significantly lower than in the stable form of the disease (18.56 +/- 1.1 nM/l) and in healthy volunteers 20.9 +/- 1.0 nM/l, p less than 0.02 and p less than 0.001 respectively. Estradiol concentrations in male patients with instable coronary disease (228.3 +/- 22.8 pM/l) and with stable form of the disease (157.0 +/- 12.6 pM/l) were significantly higher than in healthy volunteers, p less than 0.02 and p less than 0.001 respectively. The obtained results indicate gonadal disorders in male patients with coronary arteriosclerosis.

Adult↗

[The risk of complications of cerebral angiography in patients with cerebral aneurysms in relation to the time of its use].

The authors analysed the effect of cerebral angiography on the condition of the patients after haemorrhage from an intracranial aneurysm. The studied material comprised 242 patients in whom cerebral angiography was carried out at various times after the haemorrhage by the method of direct percutaneous needle insertion into the carotid artery. Complications of angiography included: worsening of the general condition or neurological condition during the angiography and within 24 hours after it. Such complications were found in 14 patients (5.8%). In only 3 cases they appeared during the angiography. No cases of repeated haemorrhage from the aneurysm were observed. The greatest risk of complications was after 7-9 days from the haemorrhage which was connected with the greatest intensity of arteriospasm at that time. All carotid angiographies were done using a contrast medium hypersmolar and hypertonic in relation to the blood and cerebrospinal fluid (Uropolinum-Polfa 60%).

Adolescent↗

[Location of cerebral aneurysms and arteriospasm after subarachnoid hemorrhage].

On the basis of an analysis of 314 patients with aneurysms situated supratentorially the authors tried to establish a possible correlation between the location of the aneurysm and the frequency, intensity and extent of this spasm. Similarly as in the reports of other authors it was not possible to find a correlation between the location of the aneurysm and arteriospasm. Only the group of 28 patients with multiple aneurysms showed the highest percent of most intense and most extensive arteriospasm, which was particularly evident within the first three days after haemorrhage. In the period from the 4th to the 6th days after the last subarachnoid haemorrhage the lowest proportion of angiograms with arteriospasm was noted in patients with aneurysms of the anterior communicating artery. In this group diffuse bilateral arteriospasm was significantly more frequent than in the remaining groups.

Adolescent↗

[Neuroradiological studies in syringomyelia].

In the years 1973--1975 20 patients with syringomyelia were treated surgically. The surgical interventions were preceded by careful radiological examinations which was often indispensable for confirmation of diagnosis, establishing of indications to operation and choice of surgical method. On plain radiograms in 16 cases cervicothoracic scoliosis was found, in 11 cases the vertebral canal was dilated in its cervical part, in 6 cases atlanto-occipital malformations were disclosed. The basic diagnostic examination was ascending myelography which was performed in 17 cases. In 3 cases the contrast medium failed to pass to the atlanto-occipital junction because of marked dilatation of the spinal cord in the cervical part. In 9 out of the remaining 14 cases radiological findings were compatible with the diagnosis of Arnold-Chiari syndrome which was confirmed during the operation. In 1 case positive contrast central pneumoencephalography was performed demonstrating a communication between the 4 th ventricle and the cavity in the spinal cord. Early detailed neuroradiological diagnosis is indispensable in syringomyelia for early surgical treatment.

Adolescent↗

[Preoperative selective embolization of intracranial meningiomas].

The authors report preliminary experiences with preoperative embolization of intracranial meningiomas describing the technique using a specially prepared gelfoam as embolizing material. Embolization was done in 3 cases, in 2 of them transient facial nerve paresis appeared as complication. The effectiveness of embolization was assessed by means of selective control intraoperative angiography and histological examination. In the conclusions the authors stress the effectiveness of preoperative embolization for reducing intraoperative bleeding and indicate the usefulness of the procedure in selected cases of other brain tumours.

Embolization, Therapeutic↗