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Biomedical subjects

M Janota

Publications and source records attributed to M Janota.

At least 19 recordsLinked to original sources
PubMed1993

[Noninvasive diagnosis of myocardial rejection using echocardiography].

The potential of echocardiography in evaluating myocardial rejection was determined in 56 patients (8 females) following orthotopic heart transplantation. The patients' average age was 42.3 (range 18-67) years. Endomyocardial biopsy was used as the reference method. The study included a total of 254 results of biopsy: 137 specimens were free of any signs of rejection while 51 showed incipient rejection and mild rejection was found in 54 specimens. Moderate rejection was detected in 12 specimens; severe rejection was not present in any case. Echocardiography was used to determine ventricular size, wall thickness, left ventricular function, pericardial effusion, mitral and tricuspid flow and isovolumic relaxation time. Rejection has been found to be associated with ventricular wall thickening; the appearance of or an increase in pericardial effusion seems to be a relatively specific feature (a very low-sensitivity marker though); change in isovolumic relaxation time is believed to be the most sensitive marker. No relation between rejection and mitral and tricuspid flow was demonstrated. Echocardiography may alert the cardiologist to a rejection episode; isovolumic relaxation time and its alterations are the most informative features in this respect. The method may help postpone the intervals of biopsy which, however, must be performed on the slightest suspicion of rejection. Still, it cannot be regarded as a replacement for endomyocardial biopsy at the moment.

Adolescent↗
PubMed1993

Precordial isopotential electrocardiographic mapping and its clinical use in patients with ischaemic heart disease.

After ten years of experience, the authors present an overview of the possible clinical uses of precordial isopotential electrocardiographic mapping in patients with ischaemic heart disease. The resting Q wave and ST segment maps have most often been found useful in the early phases of myocardial infarction. They are a helpful tool for monitoring progression of the disease, the effect of drugs, or the therapeutic effect of fibrinolytic therapy, etc. R wave mapping provides an excellent opportunity for following up patients after orthotopic heart transplantation and monitoring cardiac rejection. Stress tests are usually performed under a workload; alternative loads may be mental, pharmacological, stimulation-induced or under hypoxaemic stress. To evaluate a test, resting values are compared with those obtained during exercise. It is mainly exercise ST segment maps which have proved to be most informative; their use in the chronic phase of ischaemic heart disease helps to make the diagnosis of coronary insufficiency more accurate. In clinical practice, stress tests are recommended mostly in the follow-up of drug therapy, monitoring of the therapeutic effect of cardiac surgery or coronary angioplasty.

Coronary Disease↗
PubMed1993

Hypoxaemic precordial ST mapping in the diagnosis of coronary insufficiency.

Hypoxaemic precordial ST mapping was compared with precordial exercise mapping in a group of 64 patients. During hypoxaemia, IHD patients show ischaemic changes in ST maps similar to those found in exercise maps, and a significant increase in the sums of ST depressions. The test can be recommended to detect coronary insufficiency in cases where the exercise ECG test is not feasible or available, and to expand the arsenal of non-invasive diagnostic procedures. The physical exercise test, however, remains the strongest test for ECG detection of myocardial ischaemia.

Coronary Disease↗
PubMed1992

[Directed sympathetic denervation of the heart--an actual therapeutic method or myth?].

Aimed sympathetic denervation of the heart, i. e. bilateral removal of the stellate ganglion Th 1-Th 3 was used in Czechoslovakia since 1981 in eight patients who were followed up for prolonged periods. The patients were operated on account of angina at rest which caused deterioration of the quality of their lives. In case of extensive affection of the coronary arteries surgical treatment was not feasible and pharmacological treatment did not bring relief. At the time of a five-year check up 7 patients survived. All patients reported relief and their efficiency during ergometry improved. Four of the patients worked for several years. The authors discuss whether the above treatment is still justified.

Adult↗
PubMed1992

[Computer-assisted electrocardiographic mapping and left ventricular function in patients with acute myocardial infarct].

In 22 patients with a first myocardial infarction the authors assessed the relationship between morphological changes of the QRS complex and systolic left ventricular function. Using a 56-lead computer-assisted electrocardiogram from the precordium in the form of a map (apparatus Cardiomap-1), the authors prepared a record during the first days after initiating treatment with a thrombolytic agent and again after a period of three weeks. They found only one correlation between the decrement of Q waves and the increase of the left ventricular ejection fraction (p less than 0.05). This correlation, however, is of no practical importance due to the low correlation coefficient. The relationship is moreover markedly influenced by the time of the first record. After the third day of thrombolytic treatment it is not expedient to make the initial record. No relationship between the change of R waves, ST segments and left ventricular function was found. Similarly, due to the great dispersal of values it is not possible to differentiate between patients with inferior infarctions of the heart muscle and anterior myocardial infarctions.

Adult↗
PubMed1991

Diagnosis of myocardial ischaemia by means of precordial ST mapping and exercise 201-thallium scintigraphy.

The authors compared the results of examination by means of exercise precordial ST mapping and exercise 201-thallium scintigraphy in 43 patients with ischaemic heart disease and in 10 controls. The methods have been found to be equally helpful in establishing the diagnosis of myocardial ischaemia. 201-thallium scintigraphy is preferred when trying to quantify the lesion and to localize it. The currently available techniques of exercise EGG mapping do not always make determination of ischaemia distribution possible. The benefits inherent in either method are their non-invasiveness and good reproducibility, features making them ideal tools for assessing the effect of treatment.

Adult↗
PubMed1991

[Precordial S-T stress mapping in the evaluation of the effects of percutaneous transluminal coronary angioplasty].

The morphological impact of percutaneous transluminal angioplasty (PTCA) on the treated artery is closely checked by coronary arteriography. Indirect non-invasive evaluations are made possible by electrocardiography, isotope methods and echocardiography which are the commonest visualization methods. The authors used a precordial S-T load map. After complete revascularization following PTCA there was a significant drop of the sum of S-T depressions and in some members of the group it reached normal values. The S-T load map is a suitable non-invasive procedure for monitoring the effect of PTCA.

Adult↗
PubMed1990

[Precordial mapping of the R wave in the diagnosis of rejection after orthotopic heart transplantation].

In 15 patients after orthotopic transplantation of the heart the authors made repeated examinations of electromaps of the R wave and endomyocardial biopsies (TMB) during a long-term, at least one-year, investigation. In the detection of rejection EMB plays a dominating role. In three patients the authors found at the time of rejection a significant reduction of the R waves on maps, which correlated closely with the bioptic findings. It was revealed that maps of R waves are a good indicator of rejection of the transplanted heart. The examination may prove helpful when checking treatment of rejection but does not lead so far to a restriction of the number of endomyocardial biopsies of the heart.

Biopsy↗
PubMed1990

[Amalgam filling in clinical practice].

The quality of treatment of dental defects with amalgam is closely associated with the preparation of the cavity and its filling as well as with completion of the filling and its finish. Strict adherence of a correct working procedure improves markedly the standard of treatment and makes it possible to make use of the positive properties of amalgam from which the filling is prepared.

Dental Amalgam↗
PubMed1990

Transoesophageal atrial pacing in the diagnosis of myocardial ischaemia assessed with the 12-lead electrocardiogram and precordial ST segment mapping.

In order to diagnose myocardial ischaemia, the authors performed transoesophageal atrial pacing using commercially available electrodes and a pacing device of their own design. On assessing the 12-lead electrocardiogram, they compared the results of pacing and exercise testing in 204 subjects. They found full agreement in all controls and in most IHD patients. In 33 persons, atrial pacing was combined with assessment of the ST segment precordial mapping. On atrial pacing mapping, the authors found manifestations of ischaemia similar to those discovered during exercise testing. Both methods have proved useful in the detection of myocardial ischaemia and are recommended as alternative techniques to exercise testing, especially in cases when the latter technique is not feasible or cannot be interpreted.

Cardiac Pacing, Artificial↗
PubMed1989

[Quality of marginal sealing of Evicrol fillings when using dental adhesives in vitro].

The quality of the marginal sealing of fillings made from Evicrol in vitro was investigated by means of a couloured indicator. The close adherence of the composite filing to the surface of the tooth was ensured by the by micro retention treatment of the marginal enamel and different dentin adhesives. The thermal strain of filling materials and their combination with the tooth, corresponding roughly to conditions in the oral cavity, was modelled by cyclic temperature changes using a special apparatus designed by the authors.

Adhesives↗
PubMed1989

[Diagnosis of myocardial ischemia using functional ST mapping and 201Tl stress scintigraphy].

The authors compared the value of two non-invasive methods in the diagnosis of myocardial ischaemia, i.e. precordial working maps of the ST segment and working scintigraphy of the myocardium with 201T1 after a load. On comparison with the finding on the coronary arteries, the authors found a high sensitivity of mapping, 89.3%, and of 201T1 scan, 92.9%, while the specificity of both methods was lower, 57.1%. Both methods are equally valuable for diagnosis of myocardial ischaemia; for assessment of the site of affection thallium scintigraphy of the myocardium is preferable.

Adult↗
PubMed1988

Working capacity after myocardial infarction.

The study presents data regarding the functional assessment and prognosis of acute myocardial infarction survivors resident in Prague 4 and an industrial region in north Bohemia. No demonstrable differences between the incidence of myocardial infarction in various professions were found. Acute myocardial infarction occurred in 0.52-0.73% of the total number of workers enrolled in the study. Rehabilitation programmes succeeded in significantly increasing working tolerance, overall performance, and in decreasing the heart rate/blood pressure index within the first six months after acute myocardial infarction. In patients resuming their original jobs, all these parameters were substantially more favourable than in those not seeking re-employment. Prognosis was assessed in 1072 patients. The 10-year mortality was 52.1%. Of the survivors, 30% of patients returned to work, and 24% and 46% remained in partial and full-time retirement, respectively.

Adult↗