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Biomedical subjects

M Mikulecký

Publications and source records attributed to M Mikulecký.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Comparison of the glomerular filtration rate using renal plasma clearance of 51Cr-EDTA and biochemical methods].

In 22 patients (age 19 to 73 years) the authors examined the glomerular filtration by assessing the renal clearance of 51Cr-EDTA in addition to the plasmatic method with several blood samples, methods with a smaller number of blood samples and external assessment of the radioactivity, or else by estimation of the creatinine clearance by biochemical methods. They used as the reference method assessment of the renal plasma clearance of 51Cr-EDTA by means of a one-compartment model from the radioactivity of blood samples collected during the 60th, 120th and 180th minute. It was revealed that for the normal value of glomerular filtration (GF = 1.8 ml/s) and for its reduced value (GF = 0.5 ml/s), as compared with the reference method RP, the highest external and internal accuracy, i.e. the best agreement with the reference method and the closest interval estimates, are obtained by the single sample method RE (blood sample during the 120th minute), supplemented by three external assessments of radioactivity during the 50th-70th, 110th-130th and 170th-190th minute. The regression relationship of these methods is expressed by the following equations: RE = -8.9 + 1.06 . RP; RP = 8.47 + 0.94 . RE. The biochemical methods were, as compared with the radionuclide ones, less accurate. Their accuracy declined in the order from the calculated creatinine clearance according to Cockcroft and Gault via the inverse value of the serum creatinine concentration towards the 24-hour creatinine clearance.

Adult↗
PubMed1989

[Hemodynamic importance of the left atrium in patients with essential hypertension].

Twenty-nine patients with essential hypertension and thirty-seven without cardiac disease were examined electrocardiographically, polycardiographically and echocardiographically. Both the proportion of the left atrial systole in the hemodynamics and the size of the left atrium were significantly greater in hypertonics compared to healthy subjects. The parameters of left ventricular systolic function did not differ significantly, the parameters of diastolic function were significantly lower in hypertonics. Evaluation of the size and function of the left atrium supplements the clinical assessment of the functional state of the left ventricle at a period of its normal global systolic function but diminished diastolic function. The insufficient informative value of the electrocardiographic criteria of changes in the size of the left atrium (so-called Morris's index) and of the presence of the 4th heart sound in evaluating the severity of hypertension is pointed out. Since the presence of the 4th heart sound is clinically incorrectly interpreted, the need for consistency in its interpretation is emphasized.

Adult↗
PubMed1989

Bone alkaline phosphatase isoenzyme and urinary hydroxyproline in healthy subjects, patients with osteolytic metastases, and patients with primary hyperparathyroidism.

The values of urinary hydroxyproline excretion reflecting the bone remodelling by osteoclasts, and the bone isoenzyme of serum alkaline phosphatase reflecting the osteoblastic function, in 100 randomly selected healthy subjects, 100 patients with primary hyperparathyroidism, and 100 patients with osteolytic secondary tumorous deposits in the skeleton showed a bivariate lognormal distribution. Hotelling's test revealed highly significant differences in the biochemical values among these three conditions, even when Bonferroni's modification of the test was used. The individual biochemical values, however, displayed many mutual overlaps. Despite this, the discriminatory analysis based on bivariate biochemical data resulted in a correct diagnosis in all healthy subjects, in 82 patients with primary hyperparathyroidism, and in 93 patients with osteolytic metastases. The simultaneous determinations of urinary hydroxyproline excretion and the bone alkaline phosphatase insoenzyme improve the differential diagnosis between these conditions. The predominance of urinary hydroxyproline excretion relative to bone alkaline phosphatase isoenzyme suggests an osteolytic metastasis. Proportionately elevated both hydroxyproline and bone alkaline phosphatase isoenzyme indicate the presence of primary hyperparathyroidism. This shows the importance of a correct biometrical processing of data. Nevertheless, a complex clinical evaluation is always mandatory.

Adult↗
PubMed1988

Acute haemodynamic effect of metoprolol in essential hypertension.

The acute haemodynamic effect of metoprolol was investigated in 14 patients with essential hypertension (7 of the WHO stage I, 7 of stage II). The evaluated parameters include the mean arterial blood pressure (MBP), heart rate (HR), cardiac index (CI), total peripheral resistance (TPR) and capillary blood flow of the forearm muscle (CBF). Investigation was carried out within two days: the 1st day at rest and after an infusion of 20% mannitol, the 2nd day with additional previous intravenous administration of 5 mg of metoprolol. The findings were as follows: 1. There was a decrease of MBP, a slowdown of HR and a decrease of CBF after metoprolol both in hypertensives I and II. 2. The different haemodynamic response of the Ist and IInd stages of essential hypertension was manifested by a significant decrease of CI and an increase of TPR in hypertensives II (but not I) not only after the infusion of mannitol alone, but also after i.v. administration of metoprolol. The exaggerated haemodynamic response to acute metoprolol administration in essential hypertension II could be caused by latently impaired cardiac performance in this stage.

Adolescent↗
PubMed1987

The effect of small doses of guanfacine (Estulic Sandoz) on the lipid levels and catecholamine excretion in patients with essential hypertension.

During three-month therapy with small doses of guanfacine (Estulic Sandoz) that were sufficient to control blood pressure in patients with stage II essential hypertension and led to a decrease in excretion of noradrenaline and vanillylmandelic acid, the authors found a decrease in the level of blood cholesterol in patients with hyperlipidaemia. There was no adverse effect on the levels of triglycerides, beta, pre-beta and alpha lipoproteins. The authors conclude that Estulic therapy is indicated in patients who, in addition to essential hypertension, have hyperlipidaemia.

Adult↗
PubMed1985

Steroid diagnosis of Cushing's syndrome evaluated by pattern recognition.

Six steroid tests based on urinary free cortisol and plasma total cortisol were used for differentiating between 27 patients with Cushing's syndrome in whom the diagnosis was confirmed by operation or autopsy and 25 obese subjects imitating this syndrome in whom hypercortisolism was excluded by repeated examinations performed over several years. The complex quantified evaluation of these tests by computer pattern recognizing procedure allowed a correct classification of all subjects. The procedure quantitatively ascertained the usefulness of performing steroid tests repeatedly at due intervals for conclusive diagnosis. The response of urinary free cortisol to the low-dose dexamethasone and diurnal rhythm of plasma total cortisol appear to be the most important tests.

Clinical Laboratory Techniques↗