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J Kvasnicka

Publications and source records attributed to J Kvasnicka.

At least 37 records · Page 2Linked to original sources
PubMed1996

Atrial contribution to ventricular ejection in sequentially paced patients.

A new method for quantitative assessment of the atrial contribution to ventricular ejection in sequentially paced patients is described. The atrial contribution (AC) has been defined as the pulse pressure decrement (invasive arterial measurement by a canulla inserted into the brachial artery), expressed in percent of the control pulse pressure, induced by switching off the atrium activating impulse for one beat. In 17 patients, the AC was found to be atrioventricular (AV) interval dependent, the measurements were well reproducible (the mean difference between two measurements at different times was 93%, S.D. 8.4). For the AV interval of 170 ms, it was found to be 293% (+8.9) in patients with the sick sinus syndrome, 27.0% (+3.2) in patients with complete AV block and only 10.8% (+2.1) in a patient with complete AV block and heart dysfunction.

Aged↗
PubMed1995

[Treatment of anemia in patients with tumors].

About 30% of patients with tumors (in relation to its extent) suffer from anemia which is usually asymptomatic. Etiologically this anemia may be characterized as secondary, so called anemia of chronic diseases. Disorders of iron metabolism, blood marrow insufficiency, extracorpuscular haemolysis, catabolism of patients with tumor burden and relative deficiency of erythropoietin all play a role in its pathogenesis. Anemia of cancer patients may be usually classified as normocytic and normochromic. Indication and timing for treatment of anemia of cancer is equivocal. Successful treatment of anemia seems to improve the quality of life of cancer patients. Indication depends, of course, on the severity of anemia, degree of adaptation and the presence of clinical symptoms related to anemia. Therapy with iron or anabolics is not very effective, therapy with recombinant erythropoietin is not available for all patients, especially for its high price. Transfusion therapy should be considered more carefully in relation with some data showing the possible negative influence of allogeneic blood derivatives on the progression of tumors, especially in patients immunodeficient after high dose chemotherapy and actinotherapy.

Anemia↗
PubMed1995

[Normal blood values in the adult population in the Czech Republic].

In a group of 2033 healthy subjects-1475 men, mean age 36 years and 558 women mean age 51 years-normal values of the haemogram of the present healthy Czech population were assessed. Men: Hb 135-174 g/l, haematocrit 0.39-0.51, Ery 4.19-5.75 x 10(12)/l, MCV 82.6-98.4 fl, Leuco 4.1-10.2 x 10(9)/l, thrombocytes 142-327 x 10(9)/l. Women: Hb 116-163 g/l, haematocrit 0.33-0.47, Ery 3.54-5.18 x 10(12)/l, MCV 82.3-100.6 fl, Leuco 4.0-10.7 x 10(9)/l, thrombocytes 131-364 x 10(12)/l. When examining the haemogram it is necessary, if possible, to adhere to a standard procedure. Results must be always evaluated in conjunction with anamnestic data, the physical finding, and possible slightly abnormal values may not be always evaluated as pathological.

Adult↗
PubMed1995

[Catheterization therapy of thromboembolic arterial occlusions of the lower extremities].

Thromboembolic occlusions of peripheral arteries may threaten the vitality of extremities and sometimes patients life. Till recently the main therapeutic method was Fogarty surgical thromboembolectomy. A less invasive procedure is systemic (intravenous) and local (intraarterial) thrombolysis. All these method have, however, certain disadvantages. A new approach to the treatment for acute and subacute occlusions of peripheral arteries represents catheter thromboembolectomy, which involves the following: a) Aspiration of thromboembolic material--percutaneous thrombembolextraction (PTEE), b) Local infiltration thrombolysis where the catheter penetrates through the occlusion while simultaneously administering a fibrinolytic agent, c) PTA of residual stenosis in case of thrombotic occlusion. A combination of these methods of treatment for thromboembolic occlusions of peripheral arteries is very effective and enables to use a small amount of thrombolytic agent. The thrombosis and the underlying atherosclerotic stenosis are resolved during the same session.

Catheterization, Peripheral↗
PubMed1995

[Apoptosis--programmed cell death].

The authors summarize findings on apoptosis-programmed cellular death, incl. basic data on expression of genes promoting (p53, c-myc, MTS 1 and fas) or inhibiting (bcl-2, bcr-abl) this process. The authors discuss clinical possibilities of controlling apoptosis, in particular in oncology and in autoimmune disease, AIDS, metabolic disorders etc.

Apoptosis↗
PubMed1995

[Arrhythmogenic right ventricle].

A 26-year-old patient with an irrelevant personal and family-history was treated on account of attacks of relapsing ventricular tachycardia and cardiac failure, mostly dextrolateral. After ruling out other possible causes of the disease--such as embolism of the lungs, ischaemic heart disease, out other possible causes of the disease--such as embolism of the lungs, ischaemic heart disease, Ebstein's anomaly, the diagnosis of an arrhythmogenic right ventricle was established. This disease is suggested by negative T waves in the thoracic leads V1-V3 during sinus rhythm and by the shape of the QRS complex which was the type found in block of the Tawara branch with an axis of + 100 degrees during attacks of ventricular tachycardia. Moreover, ventricular tachycardia of the same type was produced during electrocardiographic examination. On angiographic examination ARVD is suggested by marked trabeculization and impaired kinetics of the outflow tract of the right ventricle. In the prevention of relapses of ventricular tachycardia beta-blockers and Cordarone were successful when used simultaneously with cardiac stimulation type AAI applied on account of a confirmed sinoatrial block.

Adult↗
PubMed1995

[Subacute thrombosis of the abdominal aorta with suprarenal involvement and successful treatment with pharmacomechanical fibrinolysis].

In a 43-year-old patient with Ebstein's anomaly and a history of acute myocardial infarction by means of duplex ultrasonography and aortography the diagnosis of thrombotic occlusion of the a aorta was established, starting above the insertion of the renal arteries and reaching as far as the bifurcation of the aorta and the common iliac arteries. In the clinical picture dominated complete anuria with uraemia and marked hyperkaliaemia as a result of ischaemic affection of the extremities due to thrombosis of the aorta; at the onset of hospitalization also left ventricular failure with hyperhydration and later also signs of the hyperviscous syndrome. The latter developed after repeated haemofiltrations which led to a rise of the originally high haemoglobin and haemotocrit values a result of a righ-left shunt in Ebstein's anomaly. After improvement of the clinical condition local fibrinolytic treatment of the aortal thrombosis with urokinase (total dose 2,160,000 u. administered within 24 hours) was provided. The thrombus with a total length of 13.5 cm was dissolved except for a residual portion of 10 mm located in the area of insertion of the right renal artery. After dissolution of the thrombus it proved possible to restore the blood flow into the left kidney a and lower extremities, but not into the right kidney because of the residual thrombus. Seventy-two hours after terminated fibrinolysis - and after 31 days of anuria - the diuresis was restored and after a polyuric stage normalization of mineral, urea levels was restored and the creatinine value was slightly above the upper normal range. Concurrently with fibrinolytic therapy angioplasty of the aorta was carried out and a stent was placed on the left iliac artery. The clinical condition of the patient was improving, the patient started to mount stairs. Death occurred suddenly and the cause was cardiac failure due to very serious congenital heart disease.

Adult↗
PubMed1995

[Thromboembolic complications in urology].

Using the latest examination methods the authors have proved relatively wide spread recurrence of thromboembolic complications. Proved were even the mortal forms in urology in case of benign diagnosis as well as relatively considerate operational medical performance. An evident effect of prophylactic, physical and especially pharmacological methods was proved in prevention of thromboembolic disorders. Silent form of deep venous thrombosis were diagnosed to patients with mere physical prophylaxis. On the other side unfavourable effect of low molecular weight heparin on blood loses was not proved even in laboratory picture. Higher risk of thromboembolic complications origin was observed even on the 21st postoperation day. Currently authors consult the appropriateness of individual types of prophylaxis with the different urology illnesses risk groups.

Humans↗
PubMed1994

[The fluorescence flow cytometry technique in the diagnosis of hereditary platelet disorders--a case of Glanzmann's thrombasthenia].

The authors describe a method for the diagnosis of heredital platelet membranopathies by means of monoclonal antibodies against the main membrane glycoproteins of thrombocytes, glycoprotein Ib and IIIa. The platelets are differentiated in the flow fluorocytometer from other blood cells by the typical optic profile caused by their size and granular character. Monoclonal antibodies are bound to the appropriate membrane glycoprotein and their amount is then detected by means of a secondary antibody labelled with fluorescein. The intensity of fluorescence of individual platelets is proportional to the number of molecules of the appropriate glycoprotein on their surface. By the above technique a case of Glanzmann's thrombasthenia was diagnosed, a rare hereditary haemorrhagic disease, characterized by the absence or abnormal function of glycoprotein complex IIb/IIIa the platelet receptor for fibrinogen.

Antibodies, Monoclonal↗
PubMed1994

[Administration of granulocyte-macrophage colony growth factors in the treatment of postcytostatic myelosuppresion in oncohematologic patients].

BACKGROUND: Growth factors for granulocytic and granulocyte-macrophage series (G-CSF and GM-CSF) in the form of recombinant proteins are used in various leukopenias. The aim of this work was to follow the effect of GM-CSF (Leucomax Sandoz) in myelosuppression after the therapy with cytotoxic drugs. METHOD AND RESULTS: Leucomax was given to 22 patients with oncohematological disease (3 patients with acute lymphoblastic leukemia, 5 patients with various myeloid malignacies, 4 myelomas and 10 patients with non-Hodgkin lymphomas). In comparison to the literary data lower doses of Leucomax were used, it is 150-200 micrograms a day and patient. The length of administration of the growth factor was reduced to the shortest possible time according to the leukocyte count monitoring. Leucomax administration was started when leukocytes dropped below 1.10(9), in patients with severe leukopenias after repeated chemotherapy Leucomax was applied earlier. From 17 patients treated for sufficiently long period of time 70% responded to the GM-CSF application without any serious side-effects. In most cases, with the exception of myeloma, the growth factor was applied for 4-10 days. The leukocyte increase above 3 x 10(9) appeared in 3-8 days after the start of the treatment. CONCLUSIONS: Correctly indicated application of growth factors in postcytostatic myelosuppression is a great contribution to antitumor therapy. According to our experience in most cases 5-7 days of the daily dose of 150-200 micrograms of GM-CSF is sufficient for the stimulation of leukopoiesis. In postherapeutic myelosuppression in acute myeloblastic leukemia the growth factor should be used only as a life saving therapy since it can stimulate the leukemic cell population.

Adult↗
PubMed1994

[Lymphocyte subpopulations determined by flow cytometry in chronic type B lymphatic leukemia].

BACKGROUND: For examination of surface characteristics of lymphocytes automatic analyzers of flow cytometry are used which make it possible to assess labelling with 2-3 monoclonal antibodies on one examined cell and provide thus more accurate data on the immunophenotype of proliferating cells. The objective of the present work was-using the method of flow cytometry and monoclonal antibodies-to detect surface signs on lymphocytes in the peripheral blood stream of patients with lymphatic leukaemia. METHODS AND RESULTS: In 29 patients with chronic lymphatic leukaemia type B (B-CLL) CD signs were examined, using flow cytometry and the findings were compared with those obtained in a control group of 63 healthy subjects. Evidence of CD 19+ CD5+ lymphocytes (B1 cells) in B-CLL (83.4 +/- 15% vs. 3.5 +/- 1.9% in controls) was of diagnostic importance. These CD5+ B cells are polyreactive, "memory B" lymphocytes which contrary to "conventional" lymphocytes B2 (CD5-B) do not differentiate further to plasma cells. Accumulation of B1 (CD5+ B) lymphocytes was, on the other hand, associated in patients with B-CLL with a decrease of B2 (CD5-B) lymphocytes (2.8 +/- 4.0% vs 9.0 +/- 4.2%) (p < 0.01). This finding can in case of excess of B1 (CD5+ B) lymphocytes explain the tendency of patients with B-CLL to develop autoimmune complications (e.g. AIHA); and conversely a decrease of B2 (CD5-B) lymphocytes can lead to hypogammaglobulinaemia which is also associated with B-CLL. A tendency towards autoimmunity may be also promoted by a decline of so-called inductors of suppressor cells (CD 4+ CD45RA); in patients with B-CLL among CD4 T lymphocytes 32.5 +/- 15% CD 45RA+ cells were found, as compared to 43.0 +/- 14.8% in controls (p < 0.011) and a lower ratio of true suppressor T cells (CD8+ CD11b+) in patients with B-CLL: 47.0 +/- 17.6% CD11b+ from CD8+ cells, as compared with controls 80.4 +/- 13.3 CD11b from CD 8+ cells (p < 0.01). CONCLUSIONS: The method of flow cytometry with double fluorescence thus contributes to the accurate diagnosis of B-CLL, to monitoring of the therapeutic effect but also to knowledge of the immunopathology of the disease.

Adult↗
PubMed1994

In vitro study of a radiofrequency guidewire aimed at recanalization of totally occluded peripheral arteries.

A novel radiofrequency ablative system (40 msec-train pulses with twenty 200 msec pulses at the carrier frequency of 750 KHz and 1 Hz repetition rate) aimed at recanalizing totally occluded peripheral arteries was investigated by means of in vitro tissue ablation from human postmortem arterial wall samples. The samples were submitted to irradiation with a guidewire 150 cm long, maximum diameter of ceramic tip 0.033 inch positioned perpendicular to the tissue surface in saline, contrast medium or blood using varying generator power. Ablation efficacy was determined as the depth of vaporization per pulse delivered. Electrical current for the train duration was measured as voltage at the 1 ohm-resistor. In saline, the ablation efficacy increased from 8 to 65 microns/pulse with generator power increasing from 11 W to 27.5 W. There was no significant difference in the ablation efficacy between saline and blood. In contrast medium, the ablation efficacy was significantly lower. For the same generator power, the electrical current varied during the ablation procedure from 1.3 +/- 0.2 A at the beginning of the procedure to 1.1 +/- 0.2 A after the first pulses and to 2.0 A before artery wall perforation occurred. Neither tissue ablation nor current variations were observed when radiofrequency energy was emitted on calcified tissue. The diameter of craters was 0.89 +/- 0.1 mm (range: 0.85-0.96 mm). No major thermal injury such as carbonization or charring was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Cadaver↗
PubMed1994

Early changes of serum N-acetyl-beta-glucosaminidase, tissue plasminogen activator and erythrocyte superoxide dismutase in relation to retinopathy in type 1 diabetes mellitus.

Biochemical markers of early changes that are characteristic for diabetic microangiopathy are not completely understood. We investigated activities of serum N-acetyl-beta-glucosaminidase (NAG), tissue plasminogen activator and erythrocyte superoxide dismutase in well defined groups of type 1 diabetic patients. Patients were selected on the basis of 4 year follow-up observation. Forty-two type 1 diabetic patients were subdivided into those without retinopathy (n = 13) throughout the study, those with newly developed or worsened retinopathy (n = 12) during 4 years and those with retinopathy already established at the beginning of the study and without evidence of its progression (n = 17). All diabetic patients had albustix-negative urine. A significant increase of the mean serum NAG activity during 4 years was found only in patients without retinopathy (P < 0.01) whereas no changes of the altered enzyme activities were present in patients with developing and established retinopathy. The mean activity of tissue plasminogen activator was elevated in all groups of diabetic patients compared with healthy subjects (P < 0.001). A significant positive correlation was found between plasminogen activator and serum NAG (r = 0.51, P < 0.01). Erythrocyte superoxide dismutase was higher in diabetic patients than in healthy persons (P < 0.01) but no differences were observed between the patients with or without retinopathy. Superoxide dismutase positively correlated with NAG (r = 0.57, P < 0.01). We conclude that early functional changes precede a morphological development of diabetic retinopathy as was evident from the altered enzyme activities.

Acetylglucosaminidase↗
PubMed1994

Angioscopy after laser and balloon coronary angioplasty.

OBJECTIVES: Percutaneous intracoronary angioscopy was used to study the morphologic changes occurring in coronary arteries after balloon or laser angioplasty. BACKGROUND: Angioscopy is thought to provide details of the coronary vessel lumen and the inner wall. METHODS: Coronary lesions were studied in 44 patients with a 4.5F Imagecath angioscope before and after each interventional procedure. Balloon and laser angioplasty were performed in 21 (group I) and 23 patients (group II), respectively. There was no difference in age, gender or angiographic lesion appearance before the procedure between the two groups. RESULTS: Circumferential visualization of the target lesion was successfully completed in 17 group I and 19 group II patients. A larger lumen than that observed at baseline was seen in all 17 group I and in 13 of the 19 group II patients. Tissue remnants were observed in all group I and II patients. Laser irradiation resulted in characteristic sharp-edged craters. Dissection was identified in 2 of 19 patients before versus 9 of 19 patients after balloon angioplasty (p < 0.05) and in 0 of 23 patients before versus 4 of 23 patients after laser angioplasty (p = NS). Subintimal hemorrhage was observed in 3 of 19 patients before versus 11 of 19 patients after balloon angioplasty (p < 0.05) and in 2 of 23 patients before versus 4 of 23 patients after laser angioplasty (p = NS). The frequency of hemorrhage was higher in group I than in group II (11 of 19 vs. 4 of 23, respectively, p < 0.02). CONCLUSIONS: Angioscopy provides valuable information on lesion morphology after coronary interventions. Balloon dilation results in a high rate of dissection and subintimal hemorrhage. Laser angioplasty is able to ablate obstructing tissue and results in a lower rate of subintimal hemorrhage than balloon dilation.

Aged↗
PubMed1994

Clinical results of coronary excimer laser angioplasty: report from the European Coronary Excimer Laser Angioplasty Registry.

From January 1991 to January 1993 the clinical and angiographic data of 470 patients were included in the European Coronary Excimer Laser Angioplasty Registry. Symptoms were CCS class 3 in 23% and CCS class 4 in 14.7%; unstable angina was present in 14.7% and 6.6% of patients had acute myocardial infarction. Of 477 treated lesions, 60% were type B2, and 19% type C. The lesion was located in the LAD in 61%, in the LCX in 16%, in the RCA in 20%, in a protected left main stem in 1.3% and in a saphenous vein graft in 2.5%, respectively. Failure of laser angioplasty occurred in 56 (12%) interventions. By multivariate analysis failure was associated with the intention to treat long segmental lesions (risk ratio (RR) 3.6, confidence interval (CI) 2.9 to 4.4; P = 0.0005), segments with severe prestenotic tortuosity (RR 3.5, CI 2.4 to 4.6; P = 0.02) and total occlusions (RR 2.1; CI 1.4 to 2.8; P = 0.05). Complications included vasospasm (13.4%), dissection (14.7%), flow limiting dissection (4%), reclosure (7.8%), and perforation (1.9%). Myocardial infarction occurred in 2.1%, CABG was requested in 1.9%, and the mortality was 1.5%. Procedural success was achieved in 89%. Individual morphological criteria for a reduced procedural success were the presence of a thrombus (RR 6.4; CI 5.0 to 7.7; P = 0.007) and vessel calcification (RR 2.6; CI 1.9 to 3.2; P = 0.005). Procedural success was slightly lower in type C lesions (86%) than in type B2 (88%) type B1 (95%), and type A lesions (92%), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗
PubMed1994

Percutaneous angioscopy in patients with restenosis after excimer laser coronary angioplasty.

Coronary angioscopy was performed in two patients with restenosis after excimer laser coronary angioplasty to improve our knowledge of restenosis after excimer laser angioplasty. The characteristics of the angioscopic findings in restenosis after excimer laser angioplasty consisted of smooth white plaques, which were distinctly different from the yellow plaques commonly observed in primary lesions. These findings indicate that restenosis in these patients after excimer laser angioplasty may be associated with smooth muscle cell proliferation and fibrosis.

Angioplasty, Laser↗