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J Tuma

Publications and source records attributed to J Tuma.

At least 37 records · Page 2Linked to original sources
PubMed2004

[Ultrasound for renal colic].

Nowadays the Spiral-CT-scan is stressed as the diagnostic "gold-standard" in the management of kidney-colics. Our findings suggest a very good sensitivity (98%) and specificity of diagnostic ultrasound (items:Hydrourether, RI > 0.05) in combination with hematuria in an ambulatory setting. Our data are referred to 70 ambulatory patients examined with the hypothetical diagnosis of kidney-colic in a general medicine surgery between 1996-2003. Diagnostic ultrasound is a reliable tool in the management of kidney-colics in ambulatory medicine. Its cost-saving character and the lack of X-rays-exposure should be taken into account in choosing the appropriate method in judging abdominal pains possibly related to kidney-colics.

Abdominal Pain↗
PubMed2003

[Diagnostic imaging of calculi in the upper urinary tract--sonography vs. computerized tomography].

The choice of the most suitable technique for radiologic evaluation of upper urinary tract stones depends on the precise clinical questions that have to be answered. Many of these questions can still be answered by plain films of the abdomen and excretory urography. This review addresses the value of ultrasonography and computed tomography (CT) with respect to the two most important clinical questions, i.e. 1) presence/extent of obstruction/hydronephrosis and perinephric abscess in patients with acute flank pain; and 2) precise location, number and size of calculi. Because its sensitivity is comparable with CT and it is widely available, ultrasonography in the hands of experienced clinicians/radiologists may be preferred for evaluation of patients with acute flank pain. However, it must be emphasized that ultrasonography may totally miss acute ureteral obstruction/hydronephrosis within the first 12-24 hours. In children as well as in pregnant women, ultrasonography is still the technique of choice, but it may be replaced by magnetic resonance urography in the future. For precise stone location or detection of calcifications, however, the speed, safety and accuracy of unenhanced helical CT make this the most sensitive method and therefore the technique of choice. It also detects urinary calculi more accurately and exposes patients to less radiation than the traditional combined plain abdominal film/intravenous urography. Furthermore, CT can most readily reveal alternative diagnoses in patients with acute flank pain and other intraabdominal pathologies than stones.

Humans↗
PubMed2001

[Ultrasound mammography].

The importance of breast ultrasound in the determination of a palpable mass grew in the last years, to examine the radiologically dence breast or cysts it even became the first line method. The sonographic evaluation bases on the following criteria: internal echoes, shape of the tumor, posterior shadowing or enhancement, lateral shadows, compressibility and shifting. As there are only a few pathognomic and definite findings like anechoic cysts with smooth walls and sharp borders, the majority of palpable masses may be determined only approximately without final certainty. Therefore the diagnosis has to be evaluated by combining clinical and imaging analysis but final diagnosis remains for histological examination.

Breast Neoplasms↗
PubMed2001

[Kidney parenchyma diseases].

The systematic appraisal of the kidneys with respect to differential diagnosis in ultrasonography is an important feature. The integration of the clinical point of view is essential in judging ultrasound findings that appear often moderate and aspecific, especially in respect of diffuse parenchymatous kidney-diseases. The most important characteristics of typical diffuse parenchymal disorders and focal alterations in ultrasonography are depicted.

Diagnosis, Differential↗
PubMed2001

S20098 affects the free-running rhythms of body temperature and activity and decreases light-induced phase delays of circadian rhythms of the rat.

Mammalian endogenous circadian rhythms are entrained to the environmental day-night cycle by light exposure. Melatonin is involved in this entrainment by signaling the day-night information to the endogenous circadian pacemaker. Furthermore, melatonin is known to affect the circadian rhythm of body temperature directly. A striking property of the endogenous melatonin signal is its synthesis pattern, characterized by long-term elevated melatonin levels throughout the night. In the present study, the influence of prolonged treatment with the melatonin agonist S20098 during the activity phase of free-running rats was examined. This was achieved by giving S20098 in the food. The free-running body temperature and activity rhythms were studied. The present study shows that enhancement of the melatonin signal, using S20098, affected the free-running rhythm by gradual phase advances of the start of the activity phase, consequently causing an increase in length of the activity phase. A well-known feature of circadian rhythms is its time-dependent sensitivity for light. Light pulse exposure of an animal housed under continuous dark conditions can cause a phase shift of the circadian pacemaker. Therefore, in a second experiment, the influence of melatonin receptor stimulation on the sensitivity of the pacemaker to light was examined by giving the melatonin agonist S20098 in the food during 1 day prior to exposure to a 60-min light pulse of 0, 1.5, 15, or 150 lux given at circadian time (CT) 14. S20098 pretreatment caused a diminished light pulse-induced phase shift when a light pulse of low light intensity (1.5 lux) was given. S20098 treatment via the food was sufficient to exert chronobiotic activity, and S20098 treatment resulting in prolonged overstimulation of melatonin receptors is able to attenuate the effect of light on the circadian timing system.

Acetamides↗
PubMed1998

Vulnerability to arrhythmias during social stress in rats with different sympathovagal balance.

An increased activity of the sympathetic nervous system is an important factor in the genesis of ventricular arrhythmias. Changes in average R-R interval, R-R interval variability (indirect measure of sympathovagal balance), occurrence of arrhythmias, and plasma norepinephrine concentrations were measured during a social stress episode (defeat) in two strains of rats, Wistar and wild type, which were supposed to differ in their autonomic stress responsiveness. Electrocardiograms were telemetrically recorded, and blood samples were withdrawn through jugular vein catheters from healthy, freely moving animals. R-R interval variability was estimated by the following time-domain parameters: the standard deviation of the mean R-R interval, the coefficient of variance, and the root mean square of successive differences in R-R interval. Average R-R interval and R-R interval variability measures, as well as plasma norepinephrine concentrations, indicated a higher sympathetic tone, a larger sympathetic responsiveness, and a lower parasympathetic antagonism after sympathetic activation in wild-type animals, which also showed a much higher incidence of arrhythmias (ventricular premature beats), compared with Wistar rats. These two strains might represent a valuable experimental model for studying the mechanisms (cellular/electrophysiological) responsible for the susceptibility to arrhythmias in healthy individuals exposed to stressful situations.

Analysis of Variance↗
PubMed1990

[Differential diagnosis: kidney disease in acute abdomen].

The possibilities and limitations of sonography in renal disease, which leads to acute abdominal symptoms, are introduced. While sonography yields a high diagnostic effectiveness in renal colics and acute renal hemorrhage, findings in acute parenchymal kidney disease are not specific. Yet the finding of markedly echo enhanced kidneys is suggestive of severe renal insufficiency. Uremia should moreover be considered as cause of acute abdominal symptoms in patients with typical ultrasonic morphological aspects of cystic renal disease or small kidneys. Ultrasonic morphology of a small kidney on both sides in some occasions can given certain hints of the underlying renal disease.

Abdomen, Acute↗
PubMed1983

Problem cases in renovascular hypertension.

The clinical course and response to therapy of 16 patients with various complex forms of renovascular hypertension were investigated. Reconstructive surgery and/or transluminal dilatation was either ineffective (n = 5) or could not be performed for technical reasons (n = 11). The group contained 7 patients with multilocular fibromuscular disease involving both renal arteries, two cases with multiple arteriosclerotic vascular occlusions, 3 patients with branch renal artery aneurysms, 3 with renal artery stenosis in a solitary kidney and one patient with renal artery stenosis and contraction of the contralateral kidney due to a non-vascular cause. With antihypertensive treatment, particularly with the angiotensin converting enzyme inhibitor captopril (n = 7), blood pressure could be reduced from 214 +/- 40/124 +/- 23 mm Hg to 145 +/- 23/88 +/- 9 mm Hg (P less than 0.001). In 11 of the 16 patients (69%) the values decreased to less than 160/95 mm Hg. These results suggest that, in complex forms of renovascular hypertension, antihypertensive treatment may be a potent therapeutic alternative if surgery and/or transluminal dilatation can not be performed or seem to have too high a risk.

Adult↗
PubMed1982

Prizidilol (SK & F 92657), a new vasodilator with beta-blocking properties in the treatment of essential hypertension.

The antihypertensive effect of a new vasodilator with betablocking properties (SK & F 92657) was investigated in 10 patients with mild to moderate essential hypertension. After a mean treatment period of 26,5 weeks (6,5-49 weeks) blood pressure was significantly reduced, from 168 +/- 22/106 +/- 6 mmHg to 144 +/- 19/94 +/- 12 mmHg (p less than 0.05 and 0.025). The mean dose was 410 mg (100-700 mg). Heart rate decreased slightly from 77 +/- 12 to 70 +/- 8 beats/min. Plasma renin activity and plasma aldosterone showed only minor changes. Nausea, heavy dreams, facial and hand flushing and mild depression were reported as side effects. In most patients the symptoms disappeared without reduction in the dose. In one patient anaemia developed after 7 weeks and treatment with prizidilol was stopped. A slight but statistically significant decrease in haemoglobin concentration of 1.1 +/- 0.6 g/dl was observed in 5 of the 10 patients (p less than 0.02). Thus, a mean dose of prizidilol of 410 +/- 242 mg/day had a mean blood pressure lowering effect of 24/12 mmHg. In 7 of the 10 patients (70%) diastolic blood pressure could be reduced to 95 mmHg or less. However, the observed haematological side-effects should be carefully monitored in further studies and may limit the clinical use of prizidilol.

Adrenergic beta-Antagonists↗
PubMed1981

[Compliance in hypertensive patients and patients with cardiac insufficiency].

In the present study the compliance or drug-adherence of 83 patients with hypertension (n = 66), heart failure (n = 14) or edema of non-cardiac origin (n = 3) was investigated by the urine fluorescence method over an observation period of 17.8 +/- 15.1 weeks. Mean compliance rate of all patients was 79.7%. Individual drug-adherence ranged from 0 to 100%. Half of the patients (54.2%; n = 45) had positive urine samples in all investigations performed. A quarter (25.3%; n = 21) were compliant in over 50%, whereas in 14.5% (n = 12) the drug could be detected in the urine in only 10 to 50% of the tests and in 6% (n = 5) in less than 10%. The 17 symptomatic patients (patients with heart failure and/or edemas) showed a slightly better compliance (87.0%) than patients with hypertension, who had positive urine samples in 77.3 +/- 30.1% of tests. However, the difference observed was not statistically significant. During treatment a decrease in compliance from 82% at the first visit to 73% and 75% respectively at the second and third could be observed. Finally, at the fourth and fifth consultation only 62.2% and 56% respectively of the patients had positive urine samples. Our results show a good compliance rate in our patients as compared to American studies. During treatment a continuous decrease in compliance could be observed. Our results indicate that the duration of treatment seems to be an important determinant for the patient's drug-adherence. Therefore, it appears necessary to perform compliance-improving strategies as early as after the first follow-up visits.

Adult↗
PubMed1981

[Sputum viscosity and respiratory tract obstruction in chronic unspecific airway diseases].

The relationship between the physico-chemical characteristics of sputum and pulmonary function tests was investigated in patients with chronic nonspecific airway diseases. 141 sputum specimens were categorized on the basis of neutrophil content as slightly inflammatory (mucoid), inflammatory (mucopurulent) and highly inflammatory. "Apparent" viscosity, fucose and N-acetylneuraminic acid content were determined. Forced vital capacity, forced expiratory volume in one second and maximal voluntary ventilation measurements were performed simultaneously for each patient. "Apparent" viscosity and fucose content did not differ among the sputum categories; N-acetylneuraminic acid was slightly increased in the inflammatory sputa. There was a statistically significant inverse correlation between "apparent" viscosity, forced expiratory volume and maximal voluntary ventilation. In contrast, "apparent" viscosity did not correlate with forced vital capacity. As for the bronchial glycoprotein components, fucose correlated directly with "apparent" viscosity, whereas N-acetylneuraminic acid did not. "Apparent" viscosity was approximately the same in all sputum categories; it did not depend on the sputum neutrophil frequency except in the case of the slightly inflammatory, mucoid sputa in which "apparent" viscosity correlated indirectly with the sputum neutrophil frequency. These results show that physicochemical characteristics of sputum or bronchial secretions may play an important role in obstruction of the airways in patients with chronic nonspecific airway diseases. In the case of low inflammation of the bronchi, bronchial glycoproteins produced in the hypertrophied tracheobronchial glands and goblet cells are mainly responsible for increased "apparent" viscosity. With increasing inflammation of the bronchi, factors other than bronchial glycoproteins appear to determine this flow property.

Adult↗