169 research outputs found
Analysis of thermal field in 110 kV cable systems
The paper presents the distribution of temperature field in high voltage cables, 64/110 kV, (2XS (FL)) with copper conductor, depending
on the depth of their arrangement in the soil and the soil thermal conductivity. Used to simulate the professional program NISA / Heat Transfer in the calculation using the finite element method (FEM)
Endovascular treatment of cervical intramedullary arteriovenous malformation
Intramedullary arteriovenous malformations (AVMs) in the cervical region are a rare clinical condition. They represent a therapeutic challenge, as the lesions may cause serious functional disorders due to their location within or immediately adjacent to the critical ascending and descending sensorimotor pathways. In this case report, we present a patient with a cervical intramedullary AVM that was treated with endovascular therapy. Our experience suggests that endovascular treatment is an effective and safe method for treating AVMs located in the cervical region of the spinal cord. More studies are needed to establish appropriate treatment protocols depending on the clinical course, the anatomy of the lesion, and the region in which it is found
Transient contractions of urinary bladder smooth muscle are drivers of afferent nerve activity during filling
Activation of afferent nerves during urinary bladder (UB) filling conveys the sensation of UB fullness to the central nervous system (CNS). Although this sensory outflow is presumed to reflect graded increases in pressure associated with filling, UBs also exhibit nonvoiding, transient contractions (TCs) that cause small, rapid increases in intravesical pressure. Here, using an ex vivo mouse bladder preparation, we explored the relative contributions of filling pressure and TC-induced pressure transients to sensory nerve stimulation. Continuous UB filling caused an increase in afferent nerve activity composed of a graded increase in baseline activity and activity associated with increases in intravesical pressure produced by TCs. For each ∼4-mmHg pressure increase, filling pressure increased baseline afferent activity by ∼60 action potentials per second. In contrast, a similar pressure elevation induced by a TC evoked an ∼10-fold greater increase in afferent activity. Filling pressure did not affect TC frequency but did increase the TC rate of rise, reflecting a change in the length-tension relationship of detrusor smooth muscle. The frequency of afferent bursts depended on the TC rate of rise and peaked before maximum pressure. Inhibition of small- and large-conductance Ca(2+)-activated K(+) (SK and BK) channels increased TC amplitude and afferent nerve activity. After inhibiting detrusor muscle contractility, simulating the waveform of a TC by gently compressing the bladder evoked similar increases in afferent activity. Notably, afferent activity elicited by simulated TCs was augmented by SK channel inhibition. Our results show that afferent nerve activity evoked by TCs represents the majority of afferent outflow conveyed to the CNS during UB filling and suggest that the maximum TC rate of rise corresponds to an optimal length-tension relationship for efficient UB contraction. Furthermore, our findings implicate SK channels in controlling the gain of sensory outflow independent of UB contractility
Hipotonia ortostatyczna i nadciśnienie tętnicze w pozycji leżącej w pierwotnych zaburzeniach autonomicznych. Patofizjologia, diagnostyka i leczenie
There are three diseases classified as primary autonomic failure (PAF), multiple system atrophy, Parkinson’s disease, pure
autonomic failure. Compensatory mechanisms preventing from decrease in blood pressure are inefficient in PAF. Among half
of the patients with PAF occur orthostatic hypotension (OH) and supine hypertension (SH), which are the cause of deterioration
of life quality. The treatment is based on modification of lifestyle and pharmacotherapy. Drugs used in OH may exacerbate
SH and vice versa.
Kardiol Pol 2010; 68, 9: 1057-106
Stymulacja rdzeniowa w leczeniu dławicy piersiowej
Spinal cord stimulation (SCS) is a well known method of treatment used worldwide since the 80’s of the last century. High
efficiency of SCS was observed in the treatment of various types of pain. Promising clinical results were observed in the
treatment of patients with refractory angina (RA). Reduction of angina attacks reduces doses of medications and improves
quality of life. SCS efficacy in RA is comparable to that observed among patients treated with cardiac surgery (CABG) and
percutaneous coronary intervention (PCI), with lower risk of complications and rehospitalisation. SCS is more cost effective
compared to CABG and PCI. SCS might be considered for patients who did not respond to reperfusion therapy. The mechanism
of action in RA is not well understood. It is known that SCS reduces the activity of the sympathetic nervous system, by
which improves the coronary perfusion and oxygenation of the heart muscle. It is important that SCS does not mask the pain
related to the infarct.
Kardiol Pol 2011; 69, 4: 383-38
Analiza statystyczna zabiegów wewnątrzczaszkowych przeprowadzonych w Polsce w latach 2008–2009
Background and purpose
Quantitative and qualitative analysis of neurosurgical procedures provides important data for assessment of the development and trends in the field of neurosurgery. The authors present statistical data on intracranial procedures (IPs) performed in Poland in 2008–2009.
Material and methods
Data on IPs come from reports of the National Health Fund, grouped according to the system of Diagnosis-Related Groups, group A – nervous system diseases. Data concerning the year 2009 include all IPs performed in Poland. Data from the second half of 2008 to 2009 (18 months) come from 35 neurosurgical centers in Poland, divided by provinces. We analyzed the number of IPs, the cost of procedures, duration of hospitalization and deaths.
Results
20 849 IPs were performed in Poland in 2009. The most common procedure was A12 (6807; 32.65%), and the rarest was A04 (96; 0.46%). The annual cost of all IPs was 228 599 956 PLN. Average cost of the procedure ranged from 1578 PLN (A14) to 47 940 PLN (A03). Duration of the hospitalization ranged between 3 days (A14) and 12 days (A12). The highest percentage of deaths was reported for A01 (n = 1050, 19.06%). Reports from 35 neurosurgical centers in the second half of 2008 and 2009 showed the highest number of IPs per 100 000 population in Kujawsko-Pomorskie (93) and the lowest in Wielkopolskie (27) and Podkarpackie (27). The highest number of IPs (1669) was performed in neurosurgical center Ml (Małopolskie), and the lowest (99) in W1 (Wielkopolskie).
Conclusions
A significant disparity in the number of IPs performed in different centers in Poland was observed. There are no data in the literature on the number of neurosurgical procedures performed in Poland in other periods.Wstęp i cel pracy
Analiza ilościowa i jakościowa procedur neurochirurgicznych dostarcza istotnych danych dotyczących rozwoju oraz trendów w dziedzinie neurochirurgii. Autorzy pracy przedstawiają dane statystyczne dotyczące procedur wewnątrzczaszkowych (PW) wykonywanych w Polsce w latach 2008–2009.
Materiał i metody
Dane dotyczące PW pochodzą z raportów Narodowego Funduszu Zdrowia i były grupowane wg systemu Jednorodnych Grup Pacjentów dla grupy A – choroby układu nerwowego. Dane z 2009 r. uwzględniają wszystkie PW wykonane w Polsce, dane z drugiej połowy 2008 i 2009 r. (18 miesięcy) pochodzą z 35 ośrodków neurochirurgicznych w Polsce podzielonych według województw. Analizowano liczbę PW, koszty procedur, czas hospitalizacji i liczbę zgonów.
Wyniki
W 2009 r. w Polsce wykonano 20 849 PW. Najczęstszą procedurą była A12 (6807; 32,65%), a najrzadszą A04 (96; 0,46%). Roczny koszt wszystkich PW wyniósł 228 599 956 PLN. Średni koszt procedury wahał się od 1 578 PLN (A14) do 47 940 PLN (A03). Czas hospitalizacji wahał się od 3 dni (A14) do 12 dni (A12). Największy odsetek zgonów odnotowano dla procedury A01 (19,06%; n = 1050). Analizowano raporty 35 ośrodków neurochirurgicznych w Polsce. W ciągu 18 miesięcy (druga połowa 2008 i 2009) najwięcej PW na 100 tys. mieszkańców wykonano w kujawsko-pomorskim (93), natomiast najmniej w wielkopolskim (27) i podkarpackim (27). Najwięcej PW (1669) wykonano w ośrodku M1 (małopolskie), najmniej (99) w W1 (wielkopolskie). Najczęściej raportowana była procedura A12.
Wnioski
Obserwowano znaczną dysproporcję w liczbie PW wykonywanych w różnych ośrodkach w Polsce. Brakuje danych w piśmiennictwie dotyczących liczby procedur neurochirurgicznych wykonywanych w Polsce we wcześniejszych okresach
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