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Biomedical subjects

I Pechan

Publications and source records attributed to I Pechan.

5 recordsLinked to original sources
PubMed1999

[Biochemical markers of perioperative myocardial infarct in non-cardiac surgery].

Perioperative myocardial infarction as well as other major cardiac events induced by myocardial ischemia during and after a more complex or long-lasting operation represents a permanent threat for a successful outcome. High number of cardiac ischemic events especially following major vascular surgery and in elder subjects requires early, sensitive and specific diagnostic markers. This review paper presents conventional as well as novel biochemical methods fulfilling the above mentioned criteria. Until now used estimations of traditional enzyme activities (aspartate aminotransferase and lactate dehydrogenase) are either entirely discarded or subsequently lose their importance (i.e. activities of total creatine kinase and its MB-isoenzyme) an instead modern methods that estimate the amounts of specific cardiac proteins--troponins T and I, constituents of myocardial contractile apparatus--released from ischemized heart are used. Patient's monitoring by means of these cardiac markers allows an early, rapid and reliable estimation of perioperative myocardial infarction enabling possible to arrange an immediate effective treatment. Recently the myocardial regulatory protein troponin I is considered the most specific cardiac marker the plasma level of which does not increase in acute damage and chronic diseases of skeletal muscles, nor in chronic renal failure. (Ref. 52.)

Biomarkers↗
PubMed1999

[Parameters of energy metabolism in patients after vascular reconstructive surgical procedures].

Revascularization surgery in patients with peripheral arterial occlusive disease presents an acceptable clinical model for studying the rate of ischaemia-reperfusion injury of cells and other structures of skeletal muscle of the affected extremity. Validity of carefully chosen set of biochemical parameters for determination of this injury during and after surgery as well as in the early and late reperfusion periods and during the readaptation to situation after restoration of blood circulation was verified. Blood samples were taken from the regional common femoral vein which allowed to obtain information directly from the ischaemized extremity. Analyzed biochemical parameters have given useful information about the situation in acid-base regulation, in energy metabolism as well as antioxidant capacity. These parameters were estimated in four time intervals: before aorta cross-clamping (preischaemic phase), then 30 min (early reperfusion) and 18 hours (readaptation period) after aorta-declamping. In the early reperfusion period a marked acidosis and raised carbon dioxide tension, significant increase of lactate and pyruvate levels as well as increased hypoxanthine plasma level were observed. On the contrary, in this period the lowest lipoperoxide level was found, evident in the wake of relative stability of concentration of endogenous antioxidants documented by a constant glutathione redox status that at the first postoperative day even significantly decreased as a consequence of a drop of oxidized and increased of reduced form of glutathione. Therefore, the applied biochemical parameters allow to monitor the ischaemia-reperfusion damage of afflicted region and could be used even in the study of compounds with a protective effect against possible injury of ischaemized and reoxygenized tissues. (Tab. 3, Fig. 4, Ref. 32.)

Acid-Base Equilibrium↗
PubMed1998

[In Process Citation]

The article reviews the possibilities of biochemical markers in coincidence with the assessment of prognosis in acute coronary syndromes and in the revealing of effectivity of their therapy. The current options of clinical biochemistry in many cases allow to supplement, confirm, or exclude the results of modern physical and other clinical examination methods and in this way to contribute to the accuracy of the diagnostic process, and enable to comment the prognosis and the risk measure of the patient. A significant progress has been achieved in the assessment of effectivity in thrombolytic therapy in acute myocardial infarction, where especially the series assessment of myoglobin levels or specific troponin cardiomarkers can facilitate the process of physician's decision as to the assessment of the subsequent procedure in the treatment of patients. The assessment of levels of both specific and partly less specific cardiomarkers becomes one of the criteria of the decision in coincidence with ischaemic episodes in the peri and postoperative periods (the diagnosis of peri-operative myocardial infarction). Specific troponin cardiomarkers acquire an extraordinary significance in the prediction of the measure of risk in patients with unstable angina pectoris where already one single assessment of the level of these markers is sufficient for hospitalization of the patient and thus enables to change the physician's strategy of further therapy. (Ref. 95.).

Journal Article↗