Biomedical subjects

H Podhaisky

Publications and source records attributed to H Podhaisky.

50 records · Page 3Linked to original sources

PubMed1982

[Diagnostically relevant effect and disturbance factors in Doppler ultrasound studies of the arterial system].

For the clinical use of the Doppler-sonography besides the knowledge of evident criteria of judgment also the consideration of important sources of error and factors of influence is necessary. Functional effects of obstructions of the arterial system depend on the actual flow time volume, the elasticity of the arteries and on the peripheral flow resistance. The derivation and registration of the Doppler-signals must be performed under standardized conditions. Particularly important are multifactorial changes of the width of the vessels and of the resistance in the regions of the arterioles which influence the poststenotic pressure-flow-behaviour and the results of Doppler-sonographic measurements. Apart from the central haemodynamics the functional changes depending on age concern the elasticity of the vessels and the degree of efficacy of the muscular blood supply. Patients with hypertension react on stimuli increasing the blood supply with a smaller increase of their functionally effective cross-section of the vessels. Disturbances of the peripheral haemodynamics in diabetics are to be referred to a deficit of the tonus of sympathetic vasoconstrictors due to an autonomous and may, moreover, be regarded as vasomotor compensation mechanisms in primarily haemorheologically conditioned disturbance of the microcirculation.

Arterial Occlusive Diseases↗

PubMed1982

[Angiological functional evaluation following transluminal catheter recanalization].

The percutaneous transluminal angioplasty is regarded as valuable enrichment of the therapeutical possibilities in peripheral arterial obstructive disease. Frequently by its application an arterial dilatation of the lumen and thus a local improvement of the blood supply can be achieved. As was shown by our measurements the haemodynamic factors and the quality of the prophylaxis of recidivations by medicaments have a decisive influence on the early results. Apart from clinical and X-ray morphological findings also oscillographic, Doppler-sonographic, plethysmographic and ergometric parameters are used for indication. In the same way angiological examinations of the function were performed within the further control of course and therapy. Changes of the peripheral haemodynamics could be particularly well read at the behaviour of the systolic pressure gradients and indices. When the technical and apparative prerequisites for the performance of the percutaneous transluminal angioplasty are given, the close interdisciplinary cooperation between radiologists and angiologists is important for achievement of optimum results of the treatment.

Aged↗

PubMed1981

[Vascular functional disorders in insulin-dependent diabetes].

In 60 patients with manifest diabetes mellitus of juvenile onset type in whom no peripheral macroangiopathy was present for objectifying disturbances of the vascular function angiological measurements in rest and after pedal-ergometric load were performed in the region of the lower extremity. In comparison to test persons with healthy metabolism diabetes showed significantly shorter pulse were times due to decreased elasticity of arteries. The behaviour of the rheographic and doppler-sonographic parameters corresponded to a larger and longer lasting dilatation of the muscular arterioles after load. Correlations between these functional changes and the severity of a microangiopathy (retinopathy) or their ascertained influence factors could not be proved in the examined number of patients. Disturbances of the haemodynamic vasomotor function are in diabetes above all to be evaluated as signs of the autonomous neuropathy. Moreover, the regulation of the blood supply changed under muscle work is connected with an increased catecholamine-conditioned stimulation of adrenergic beta 2-receptors of the vascular wall and further local metabolic as well as haemorheologic deviations.

Adrenergic beta-Agonists↗

PubMed1981

[Factors having an effect on Doppler-sonographic blood pressure determinations and their clinical significance].

In indirect measurements of the blood pressure with the help of the ultrasound-Doppler-method important influence factors and sources of errors are to be taken into consideration. In order to estimate the importance of restricted vascular compressibility, changed tissue conditions and different position of the body, pressure measurements in patients with arterial obstructive disease and in test persons with healthy vessels were performed. The mediasclerosis leads to an extensive rigidity of the arterial wall so that falsely high measuring values could be established which were lying significantly above the intravasal pressure. For examination in the femoral region of a cuff of the standard breadth in relation to the volume of the extremity is too narrow to guarantee a lossless transmission of the pressure on the artery. After passive change of the position also in the poststenotic region significant changes of the pressure can be proved. As is shown by the results the desired diagnostic evidence with the help of the Doppler pressure is to be got only in such a case, when relevant influence factors are considered and the measurement is performed under standardized conditions.

Arterial Occlusive Diseases↗

PubMed1981

[Evaluation of disordered peripheral hemodynamics after ergometric load].

In 23 patients with arterial obstructive disease of type of femoropopliteal localization (stage I and II after Fontaine) comparative oscillographic and doppler-sonographic examinations were performed in rest and after standardized dynamic muscle work. Depending upon the haemodynamic importance of the present obstructions of the arterial system after load a significant increase of the systolic pressure gradient could be proved with decrease of the oscillometric indices. The determination of haemodynamic parameters after ergometric load serves to the objective judgment of the function in vascularly conditioned claudication and it is, moreover, important for the recognition of early changes (asymptomatic stage I). Load tests are indicated always in such cases when the findings under conditions of rest do not allow an unequivocal judgment or discrepancies between subjective functional capacity and ischaemically conditioned restriction of the function are to be supposed.

Adult↗

PubMed1981

[Extracardiac hemodynamic effects of the calcium antagonist nifedipine].

For the purpose of testing extracardial haemodynamic effects of the calcium antagonist nifedipine (corinfar) in 15 patients with arterial obstructive disease and in a control group plethysmographic and doppler-sonographic measurements before and after oral application of the substance were performed. In these cases after the application of nifedipine a significant increase of the blood flow in the crural region developed. At the same time a slight decrease of the systolic pressure could be established at the upper and lower extremity. In patients with arterial obstructive disease these haemodynamic reactions had a less significant result. They correspond to an arterial vasodilatation with decrease of the peripheral resistance and simultaneously they explain a part of the antianginous effect of the calcium antagonist. The increase of the blood flow which is to be objectified after the application of nifedipine also in poststenotic areas might be of clinical importance particularly in the combined occurrence of atherosclerotically conditioned disturbances of the blood supply of the coronary and peripheral vascular system.

Arterial Occlusive Diseases↗

PubMed1981

[Evaluation of function in the clinically early stages of arterial occlusive disease].

In order to prove inhibitions of the arterial system in the region of the lower extremities and for the judgement of their haemodynamic efficacy Doppler-sonographic measurements of the systolic pressure in patients in the asymptomatic stage I after Fontaine were performed. With regard to the early recognition and judgment of the function the behaviour of the peripheral blood pressure concerning the standardized work of the muscles of the arterial ischaemia, measured at size and duration of the induced decrease of pressure, proved to be particularly evident. Diagnostic informations going beyond the examination under conditions of rest could be brought so that the functional test is particularly suitable for the recognition of early clinical stages the arterial obturation disease in the region of the extremities.

Angiography↗

PubMed1981

[Poststenotic systolic pressure and blood flow measurements during intra-arterial and vasoactive therapy].

In 34 male patients with peripheral arterial occlusive disease of the lower extremities the individual responsibility to an intraarterial adenosine triphosphate infusion was tested with the help of Doppler-sonographic poststenotic measurements of the systolic blood pressure as well as comparatively to this by determination of the arterial blood-flow in rest in the region of the calf. While the greater part of the patients with occlusive disease reacted with a significant increase of the blood supply, nearly with the same frequency a decrease of pressure or no change could be established concerning the behaviour of the peripheral pressure. For the judgment of the efficacy of an intraarterial infusion treatment in the acute experiment plethysmographic measurements of the blood-flow are, therefore, more suitable and should be preferred to Doppler-sonographic pressure parameters. As to the controls of long-term therapy under conservative treatment as well as for the judgment of the success in the reconstructive surgery of vessels, however, the post-stenotic measurements of the pressure stood the test apart from further methods in clinical practice.

Adenosine Triphosphate↗

PubMed1979

[Disorders of the arterial blood supply in the upper extremities].

Arteriopathies of the upper half of the body may lead to considerable functional disturbances of the arm and severe deficits on the part of the central nervous system. Due to good comparison they scarcely cause or do not cause any complaints in a no unconsiderable part. The clinical material consisting of 4,162 patients from five annual courses had in 9.2% occlusion and stenoses localized in the supraaortic and brachial region. The in most cases systemic angiopathy here explains the frequently combined appearance with arterial processes in the pelvic and the leg region. According to the height of the occlusion we clinically differ types of carotis, shoulder girdle, upper arm and peripheral-acral obliteration, which in each case show differences concerning frequency, age of manifestation, etiology, distribution of sex and clinical degree of severity. The angiological basic diagnostics is based on the inspection, palpation of the arteries, auscultation of the vessels, bilateral measuring of the blood pressure after Riva-Rocci and functional examinations, such as fist closure test and Allen test, as well as clinical proofs or exclusions of neurovascular syndromes of the shoulder girdle. The special apparative angiological methods comprise the oscillo-, rheo- and vein occlusion plethysmography, the Doppler ultrasound technique, estimations of the ophthalmic pressure, isotopic methods and angiographic exploration. --The individual angiological examination methods are of different importance according to the height localisation of the angioorganopathy. --The incomplete syndrome of the aortic arch is taken into consideration. In short the author adopts a definite attitude to the demands of therapy.

Adult↗

PubMed1979

[Ultrasound diagnosis in arteriosclerosis obliterans].

From the standpoint of the clinical angiology the ultrasound Doppler method is of great diagnostic evidence. By means of this method depending on physico-technical and apparative prerequisites we succeed in judging the movements of blood in the non-invasive way. Of particular relevance is the sonographic investigation after Doppler of the extracranial part of arteries supplying the brain. In the region of extremities the poststenotic pressure measurings after Doppler give the possibility to establish early clinical stages and to objectify the degree of compensation of arterial circulatory obstructions.

Angiography↗

PubMed1979

[Doppler-sonographic findings in media sclerosis of the extremities, verified by radiography].

23 patients were examined who in the ultrasound-Doppler-pressure measurement were evident by too large peripheral systolic measuring values. On the X-ray pictures of the soft tissues of these patients more or less expressed linear and longitudinal calcifications of the vascular wall in the sense of a Mönckeberg sclerosis of the media were to be proved. Though these changes of the arteries which are to be established in most cases in diabetics of older age do not cause, as a rule, any disturbances of the peripheral blood supply, they are of clinical interest, since they falsify the results of indirect measurements of the pressure (pseudohypertension). An arterial obstructive disease which is simultaneously present may possibly been overseen and the false diagnosis of a therapy-resistant arterial hypertension may be made.

Adult↗

PubMed1977

[The spontaneous rhythm of the peripheral blood supply in diabetics needing insulin].

In order to study the spontaneous rhythmics of the peripheral blood supply under diabetic metabolic onditions with the help of venous occlusion plethysmography quantitative measurings were carried out in 20 long-term diabetics treated with insulin and in an adequate control group with healthy metabolism. The results were significant differences of the sizes of blood flow in rest as well as in the behaviour of the amplitudes and in the course of time of the spontaneous rhythmical varieties of the blood supply. Influences of age and duration of diabetes could not be proved on the basis of the number of patients. As to their evidence the findings are discussed with regard to the pathogenesis and early recognition of the diabetic neuro- and angiopathy.

Adult↗

PubMed1977

[Investigation by borrowing-lending-phenomenon under conditions of intraarterial induced vasodilatation (author's transl)].

In fourty patients with peripheric atherosclerosis obliterans blood flow was measured by means of venous occlusion plethysmography during an intraarterial and an intravenous infusion of ATP. The intraarterial application showed a significantly higher increase of blood flow than the intravenous in the sick extremities. The "borrowing-lending-phenomenon" happened more seldom than after an intravenous load. This withdrawal of blood occurred most frequently in patients with proximal occlusions, when the infusion reached casually the arteria femoralis profunda only. The "borrowing-lending-phenomenon" can be measured by the poststenotic pressure and by the volume of blood flow in time. Then the patients complain about a begining or an increasing of an ischemic pain at rest.

Adenosine Triphosphate↗

PubMed1975

[Angiological criteria of the functional capacity in arterial occlusive diseases of extremities after vascular surgery].

In order to avoid wrong estimations of the functional capacity of extremities with successfully reconstructed vessels in angioorganopathies, the use of reliable angiological measuring sizes in a broad spectrum is needed. Oscillography and longitudinal rheography as well as determinations of the arterial blood pressure deliver such qualitatively reliable parameters. For the judgment of the postreconstructive functional capacity one must not renounce the occlusion plethysmography of the veins which delivers quantitative measuring sizes. Other disturbances of the organs by the vascular basic disease present and concomitant diseases of middle and older age independent on the basic disease must always be taken into consideration in the general judgment.

Arterial Occlusive Diseases↗