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H Podhaisky

Publications and source records attributed to H Podhaisky.

At least 19 recordsLinked to original sources
PubMed2004

Prevention of deep-vein thrombosis after total hip and knee replacement. Low-molecular-weight heparin in combination with intermittent pneumatic compression.

After total hip (THR) or knee replacement (TKR), there is still an appreciable risk of developing deep-vein thrombosis despite prophylaxis with low-molecular-weight heparin (LMWH). In a prospective, randomised study we examined the efficacy of LMWH in combination with intermittent pneumatic compression in patients undergoing primary unilateral THR or TKR. We administered 40 mg of enoxaparin daily to 131 patients combined with either the use of intermittent pneumatic compression or the wearing of graduated compression stockings. Compression ultrasonography showed no evidence of thrombosis after LMWH and intermittent pneumatic compression. In the group with LMWH and compression stockings the prevalence of thrombosis was 28.6% (40% after TKR, 14% after THR). This difference was significant (p < 0.0001). In the early post-operative phase after THR and TKR, combined prophylaxis with LMWH and intermittent pneumatic compression is more effective than LMWH used with graduated compression stockings.

Adult↗
PubMed2004

Hyperhomocysteinemia: marker of systemic atherosclerosis in peripheral arterial disease.

AIM: Patients suffering from peripheral arterial disease (PAD) are increasingly described as having hyperhomocysteinemia more than in patients with coronary artery or cerebrovascular disease. Cases of symptomatic PAD usually present with associated coronary artery or cerebrovascular disease and renal artery disease. It can thus be postulated that multilocular atherosclerosis is linked to hyperhomocysteinemia and that the extent of atherosclerosis has a possible correlation with homocysteine concentrations. The aim of this study was to ascertain whether fasting total homocysteine concentrations in patients with PAD are associated with the extent and the localization of systemic atherosclerosis in cerebrovascular, coronary and/or renal vascular zones. METHODS: A total of 183 patients with PAD, Fontaine stages II-IV, were divided into 2 groups: Group A contained patients with isolated PAD (n=98) and Group B patients with systemic atherosclerosis in PAD (n=85). Characterization of vascular disease in various vascular zones was indication-adapted using non-invasive and/or invasive METHODS: Patients with renal insufficiency were excluded from the study. RESULTS: Homocysteine concentrations were significantly lower in patients with isolated PAD than in patients with additional systemic atherosclerosis (10.1+/-4.4 vs 16.7+/-7.04 micromol/l, p<0.0001). There were no differences in localization or extent of concomitant systemic atherosclerosis. Logistic regression analysis indicated that elevated plasma homocysteine and decreasing ABPI served independently as significant risk indicators for systemic atherosclerosis in patients with PAD (p<0.0001). CONCLUSION: Hyperhomocysteinemia is a precursoral marker of systemic atherosclerosis and thus a prognostic indicator of cardiovascular morbidity and mortality in PAD.

Aged↗
PubMed2002

[Cerebrovascular insufficiency--1. How to reduce the risk of stroke].

Extracranial stenosis of the carotid artery may lead to cerebral ischemic events and stroke. For this reason, such symptoms as transient ischemic attacks (TIA), unilateral syndrome or amaurosis fugax, the arteries feeding the brain should be investigated. In addition to bilateral palpation and auscultation of the arteries, modern ultrasonographic methods have an important role to play. The aim of treatment is secondary prevention of ischemic stroke, and possibly even to achieve regression of the vascular lesion. This necessitates the elimination of atherogenic risk factors. Particularly suitable as preventive medication, are platelet aggregation inhibitors, such as, acetylsalicylic acid and clopidogrel, which can also be applied postoperatively and postinterventionally to prevent recurrence.

Carotid Artery, Internal↗
PubMed2001

Calcium waves in agarose gel with cell organelles: implications of the velocity curvature relationship.

Calcium oscillations and waves have been observed not only in several types of living cells but also in less complex systems of isolated cell organelles. Here we report the determination of apparent Ca2+ diffusion coefficients in a novel excitable medium of agarose gel with homogeneously distributed vesicles of skeletal sarcoplasmic reticulum. Spatiotemporal calcium patterns were visualized by confocal laser scanning fluorescence microscopy. To obtain characteristic parameters of the velocity curvature relationship, namely, apparent diffusion coefficient, velocity of plane calcium waves, and critical radius, positively and negatively curved wave fronts were analyzed. It is demonstrated that gel-immobilized cell organelles reveal features of an excitable medium. Apparent Ca2+ diffusion coefficients of the in vitro system, both in the absence or in the presence of mitochondria, were found to be higher than in cardiac myocytes and lower than in unbuffered agarose gel. Plane calcium waves propagated markedly slower in the in vitro system than in rat cardiac myocytes. Whereas mitochondria significantly reduced the apparent Ca2+ diffusion coefficient of the in vitro system, propagation velocity and critical size of calcium waves were found to be nearly unchanged. These results suggest that calcium wave propagation depends on the kinetics of calcium release rather than on diffusion.

Animals↗
PubMed2000

Angiotensin-converting enzyme gene insertion/deletion polymorphism and carotid artery wall thickness in patients with peripheral arterial occlusive disease.

BACKGROUND: It has been suggested that the deletion polymorphism of the angiotensin converting enzyme (ACE) gene is linked to a high risk of cardiovascular disease. The relationship between the insertion/deletion (I/D) polymorphism of the ACE gene and the carotid intima-media thickness in patients with peripheral arterial occlusive disease is unknown. We tested the hypothesis that the early progression of atherosclerosis in the extracranial carotid arteries in patients with peripheral arterial disease is associated with a genetic predisposition. METHODS: This prospective trial included 98 patients who only had manifestations of arteriosclerotic disease in peripheral arterial vascular regions of the lower extremities (stable stage II PAOD). Maximal common carotid intima-media thickness (mIMT) was measured using high resolution B-mode ultrasonography. Determinations of ACE gene polymorphism were made using a polymerase chain reaction technique. Multivariate regression analysis was performed to assess the influence of ACE genotypes, ACE activity and vascular risk factors on intima-media thickness. RESULTS: There was no significant association between intima-media thickness and ACE gene polymorphism. History of symptomatic peripheral arterial disease without local or systemic progression exists in subjects with the II-genotype significantly longer than in subjects with the DD genotype (p=0.01). With the presence of an II-genotype, there was also a tendency towards a thinner intima-media thickness. We found significant correlations between intima-media thickness and age (p<0.0001), fasting serum insulin (p=0.001), and lipoprotein (a) (p=0.008). CONCLUSIONS: In the present study involving patients with stage II peripheral arterial occlusive disease, ACE gene polymorphism could not be identified as a determining marker for the development of intima-media thickening in the common carotid artery. However, it can be assumed that there is a reduced risk for the systemic progression of atherosclerosis in patients with the II genotype.

Arterial Occlusive Diseases↗
PubMed1999

Sarcoplasmic reticulum vesicles embedded in agarose gel exhibit propagating calcium waves.

In different cell types, activation of signal transduction pathways leads to the generation of calcium oscillations and/or waves. Due to this important impact for cellular function, calcium waves are the subject of intensive investigations. To study interactions of cell organelles with no influence of the cell membrane, sarcoplasmic reticulum (SR) vesicles and well-coupled mitochondria were reconstituted. For the first time, we demonstrate the generation and propagation of calcium waves in a suspension of sarcoplasmic reticulum vesicles, embedded in an agarose gel. The propagation dynamics resemble those of calcium waves in living cells. Moreover, the addition of well-coupled mitochondria leads to more pronounced and significantly faster propagating waves, demonstrating the importance of the mitochondrial Ca(2+) transport. The experimental and simulation results indicate the resemblance of the in vitro system to an excitable medium.

Aniline Compounds↗
PubMed1998

[Ultrasound image of the hypothenar hammer syndrome].

UNLABELLED: A traumatic lesion of the ulnar artery (Hypothenar Hammer Syndrome, HHS) is a very rare cause of acral ischemia of the upper extremity. AIM: Evaluation of the efficacy of ultrasound techniques in the diagnosis of the HSS. METHOD: Based on the knowledge of the patient's history and clinical examination we investigated forearm, hand and digital arteries by continuous wave Doppler. By means of colour-coded duplex sonography (CCDS) we demonstrated the course of the radial and ulnar arteries to the palmar arch. For comparison we used the results of preintervention angiography. RESULTS: The diameter of the distal ulnary artery measured in healthy women was 1.8 +/- 0.32 and in men 2.2 +/- 0.46 mm. Among 268 patients with ischemia of the hands we diagnosed HHS in four cases. We identified an aneurysm of the ulnary artery in one case and a thrombotic occlusion in three cases. The thrombotic occlusion of the ulnar artery led to a dilatation of the vascular lumen. The occlusion length could be determined. Vessels diameter and echogenecity gave information about the age of the thrombosis. CONCLUSION: The continuous wave Doppler is a major diagnostic contribution because of its ability to register hemodynamic changes. Additionally, CCDS with its combination of sonomorphology and hemodynamics enables a distinction between HHS and other causes of digital ischemia. The CCDS more precisely refines the indications for preinterventional angiography in acute ischemia syndromes of the hand.

Adult↗
PubMed1998

[Quantitative sonography of peripheral arteriovenous malformations].

UNLABELLED: Congenital vascular malformations occur in 1.5% of the general population. Depending on their localization and morphology, with dysfunction of local and central hemodynamics as well as tissue metabolism, congenital peripheral arteriovenous malformations (AVM) are of particular importance within the larger, heterogeneous group of diseases which comprise vascular malformations. AIM: The aim of this study was to evaluate our ability to quantity peripheral congenital AVM using sonographic, functional-hemodynamic, and morphological parameters. METHOD: Apart from obtaining a medical history and applying clinical and venous occlusion plethysmographic diagnostics, sonographic examinations of peripheral arteries and veins using cw-Doppler sonography and color-coded duplex sonography were performed on 8 patients with peripheral congenital AVM. For comparative purposes, the results of pre-intervention angiography examinations were also considered. RESULTS: For a sonographic quantification of AVM at the time of diagnosis, during assessments of diseases progress, and postinterventionally, both the resistance index of Pourcelot and measurement of the vascular blood flow velocities appeared to be particularly appropriate as functional-hemodynamic parameters. The sonomorphological parameters reflect the individual vascular pathology, which is determined by hemodynamic changes. CONCLUSION: Functional-hemodynamic and sonomorphologic parameters allow a quantification of AVM. With knowledge of the clinical picture acquired at the time, they provide the basis for deciding upon a more extensive pre-interventional invasive radiological diagnosis.

Adult↗
PubMed1998

Angiotensin-converting enzyme gene insertion/deletion polymorphism and peripheral arterial occlusive disease.

BACKGROUND: The deletion polymorphism of the ACE gene is linked to a high risk of cardiovascular disease due to the permanent activation of the local and systemic renin-angiotensin systems (RAS). The aim of this prospective study was 1. to compare the ACE insertion/deletion polymorphism in individuals with a healthy vasculature with that of patients suffering from peripheral arterial occlusive disease (PAOD), and 2. to determine whether associations existed between specific clinical parameters and the ACE genotype which the PAOD patients expressed. PATIENTS AND METHODS: Determinations of ACE I/D gene polymorphism were made using a polymerase chain reaction (PCR) technique on 98 patients with clinical stage II PAOD according to Fontaine and 240 healthy individuals who served as controls. All patients and controls came from central Germany. Clinical variables which included duration of clinical symptoms, a familial history of the disease, arteriosclerosis score (ASF, providing an estimate of the extent of atheromatosis at femoral artery bifurcation) and plasma ACE activity were correlated with the genotypes taking the cardiovascular disease risk factors which were present into consideration. RESULTS: Differences in ACE genotypes between patients with PAOD (D/I: 0.57/0.43) and control group individuals (D/I: 0.59/0.41) were not observed. In comparison with the II genotype, the DD genotype was associated with a shorter duration of disease (p = 0.01), a positive family medical history (p = 0.022) and a higher plasma ACE activity (p = 0.026). The ASF did not correlate with the ACE I/D gene polymorphism. CONCLUSION: Evidence that the deletion allele is linked to the manifestation of PAOD could not be found in the patients studied. One can assume, however, that the deletion allele has a progression promoting effect on the disease.

Aged↗
PubMed1995

[Media sclerosis: a case of pseudohypertension].

A 51-year-old diabetic showed symptoms of a hypertensive crisis with a systolic blood pressure above 300 mmHg. The antihypertensive therapy failed and the Doppler-pressure values were also too high for all limb arteries. Duplex-sonography and soft-x-ray examination showed a mediasclerosis of arms and legs. The true pressure, measured at the still compressable arteries of the fingers was relatively low. There was symptomatic improvement after completion of the antihypertensive therapy.

Arm↗
PubMed1994

[Doppler ultrasound evaluation of blood flow direction in distal occlusion of arteries of the lower leg].

It is necessary to observe the direction of the blood flow for measurement of the ankle pressure by the Dopplermethod. Obliteration of the ankle pressure by the Dopplermethod. Obliteration of the anterior tibial artery can be compensated by collaterals from the posterior tibial artery. Through this the blood flow is reversed in the dorsalis pedis artery. If this possibility is disregarded, the pressure of the anterior tibial artery will yield false data. The situation of the blood flow can be clarified by a compression test of the posterior tibial artery. This also applies to obliterations of the other arteries of the ankle.

Arterial Occlusive Diseases↗
PubMed1993

[Arterial vascular diagnosis by Doppler pulse curve analysis of the first dorsal metatarsal artery].

In patients with peripheral arterial occlusive disease diagnostics by Doppler-sonography at the toe arteries and by Doppler-pressure measurement at the ankle arteries is often difficult and sometimes impossible. Using the first dorsal metatarsal artery for Doppler-waveform analysis yields exact information on haemodynamically relevant circulatory disturbances. Painful ulcers, gangrene, oedemata, mediasclerosis, burns, plaster casts, posttraumatic or postoperative conditions prevent the application of cuffs at the lower leg or foot. This Doppler-waveform analysis evidently represents the degree and the specialties of a disturbed blood circulation and allows an additional assessment of the vessels distal from the ankle arteries and enables a functional test on the anastomosis of the artery tibialis posterior and the artery dorsalis pedis. Functional and pharmacological influences on the tone of the vessels can be shown. The typical diagnostic features of Doppler-wave-form analysis used at the proximal measuring points are also valid at the dorsal metatarsal artery. The results of own comparative investigations in 69 patients and 44 healthy test persons are demonstrated.

Adult↗
PubMed1992

[Incomplete thrombosis of the inferior vena cava, a cause of chronic recurrent lung embolism. Diagnostic possibilities and case report].

Detection of complete inferior vena cava thrombosis is relatively simple because of the clinical symptoms and the pathological results of cw Doppler sonography in the region of the common femoral vein. Drainage volume detectable by means of venous occlusion plethysmography is considerably reduced during the acute phase, but normalizes with increasing degree of collateralization. In case of incomplete inferior vena cava thrombosis clinical signs, cw. Doppler sonography and venous occlusion plethysmography are not very relevant. Therefore, imaging technique is additionally required. Basing on a case report, the article demonstrates that ultrasound-B-method and echocardiography, or preferable endoechocardiography, may contribute to a more reliable diagnosis. Cavography is still the gold standard if invasive therapy is planned.

Adult↗