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Biomedical subjects

O Topolcan

Publications and source records attributed to O Topolcan.

At least 37 records · Page 2Linked to original sources
PubMed2000

Endogenous fibrinolysis in patients with lower extremity ischemia.

To explore the relationship between disorders of endogenous fibrinolysis and thrombosis in patients with lower extremity ischemia, we measured the activity of tissue plasminogen activator (tPAac) and plasminogen activator inhibitor (PAlac) and the antigens of tissue plasminogen activator (tPAa) and inhibitor (PAla) in plasma from 420 patients treated for lower extremity ischemia. Values and ratios observed were compared with those in healthy volunteers. Additionally, values and ratios in the patients were examined with respect to the severity of ischemia and site of atherosclerotic occlusion or stenosis (pelvic compared with femoropopliteal or crural). Patients with lower extremity ischemia had higher plasma concentrations of PAla (p<0.01) and PAlac (p<0.0001) than healthy volunteers. In patients with rest pain or gangrene, the ratio of tPAac to PAlac was higher than in patients with claudication (p<0.05). The elevation of tPAac in patients with the more severe form of lower extremity ischemia is probably the feedback protective reaction on prothrombotic mechanisms of the organism suffered from severe atherosclerosis. Results did not vary according to the site of occlusion or stenosis. Our study found defects in endogenous fibrinolysis in patients with lower extremity ischemia. A defect in fibrinolysis may contribute to the development of thrombosis in native arteries and bypasses.

Adult↗
PubMed2000

Cytokines as plasma markers of abdominal aortic aneurysm.

UNLABELLED: The pathogenesis of abdominal aortic aneurysms (AAA) is a complex process in which atherosclerosis and inflammation play a leading role. Cytokines are important mediators of both processes. The aim of our study was to determine whether plasma levels of cytokines which are most involved in AAA pathogenesis can be used as endogenous markers of AAA development, and thus to facilitate the decision on surgical intervention in cases when this is clinically unclear (e.g. small AAA). In the prospective study a total of 90 patients with AAA were examined. These patients were divided into the following groups according to symptoms and AAA diameter: symptomatic AAAs, including ruptures (n=16); asymptomatic AAAs (n=74); AAAs with a diameter of up to 5 cm (n=30), AAAs of 5-8 cm (n=38), and AAAs with a diameter over 8 cm (n=22). The average age of the patients was 70.7 (56-82) years. The male to female ratio was 4:1 (71:19). A control group consisted of 30 healthy individuals of similar age and sex presentation with no manifestation of atherosclerosis. Plasma levels of cytokines were assessed in venous blood by means of radio- or enzymo-immunoassay. Statistical processing of the results was conducted with ANOVA and Wilcoxon tests with Spearman correlation, where p<0.05 was considered to be statistically significant. Plasma concentrations of cytokines were significantly higher in AAA patients than in healthy individuals. In AAA patients the tumour necrosis factor-alpha (TNF-alpha) and interleukin (IL-8) levels were low in large and in symptomatic AAAs. IL-6 levels were increased with increasing AAA diameter and symptoms. IL-8 levels (p<0.05) showed a statistically significant correlation with the diameter, and TNF-alpha (p<0.05) with the symptoms of AAA. IL-1beta, IL-2 and IL-6 did not show any significant changes with different AAA diameter or symptomatology. IN CONCLUSION: IL-8 and TNF-alpha can be used as endogenous markers of the process of AAA development, in deciding for either surgical or endovascular treatment of patients when the clinical indication is not entirely clear.

Aged↗
PubMed2000

Plasma and tissue levels of collagen types I and III markers in patients with abdominal aortic aneurysms.

BACKGROUND: To study the levels of the aminoterminal propeptide of type III(PIIINP) and carboxyterminal propeptide of type I procollagen (PICP) in plasma and in the wall of abdominal aortic aneurysms in relation to their size and symptomatology. PIIINP serves as a marker of turnover and PICP as a marker of the synthesis of the corresponding collagens. METHODS EXPERIMENTAL DESIGN: A prospective non-randomised study. SETTING: University Hospital, Plzen, Czech Republic. PATIENTS: Eighty-six patients who underwent resection of abdominal aortic aneurysms, average age 70.1 years (range 45 to 91 years), men to women ratio 5:1. The indication for resection was its symptomatology without relation to its diameter, and diameter over 5 cm in asymptomatic patients. Twenty patients (with similar age and gender distribution) scheduled for hernia repair or laparoscopic cholecystectomy were examined as a control group. MAIN OUTCOME MEASURES: The plasma and tissue PICP and PIIINP concentrations were evaluated using radioimmunoassay methods. The plasma samples were taken from the cubital vein without the use of a tourniquet. Full-thickness sections of the anterior abdominal aortic aneurysm wall at the site of the largest aneurysm diameter were taken at the time of operation. RESULTS: A significant difference between plasma PIIINP levels in patients with abdominal aortic aneurysms and the control group was observed (p<0.01). No correlation of PICP, PIIINP plasma levels with diameter and symptomatology of abdominal aortic aneurysms was found. The increase in PHIIINP tissue concentration was significant in patients with increasing diameter and positive symptomatology (p<0.01). No statistically significant correlation between plasma and tissue PICP and PIIINP concentrations was observed. CONCLUSIONS: The metabolism of type III collagen is increased in patients with abdominal aortic aneurysm, in contrast to type I collagen. The result is a degradation of collagen in the aneurysmal wall. The turnover of type III collagen increases with the enlargement of the aneurysm diameter and with the positive symptomatology. Degradation of type III collagen in the aneurysmal wall has therefore a fundamental significance for abdominal aortic aneurysm rupture. Because no correlation between plasma and tissue levels of PIIINP was found, the plasma levels of PIIINP cannot be used as the plasma markers of this process.

Aged↗
PubMed2000

[Leptinemia in obese children during health spa therapy].

Leptin values were investigated during four week treatment of obese children by weight reducing diet and dosed physical activity, controlled by sport-testers. Leptin values correlated significantly with BMI and HDL-cholesterol at the beginning of spa treatment and at the end of treatment. Values of leptin at the beginning of treatment correlated with fasting insulinaemia. There were no changes in leptin values during oral glucose tolerance test. Significant decrease of BMI, total cholesterol, LDL-cholesterol, triglycerides, systolic BP and leptin values appeared after four week treatment. Leptin values did not correlate with total or LDL-cholesterol at the beginning or at the end of the treatment and leptin values were not predictive for development of atherosclerosis.

Adolescent↗
PubMed2000

[The role of cytokines in peritoneal dialysis].

Peritoneal dialysis is a method of renal replacement therapy which has been increasingly in use worldwide and, in recent years, also in our country. A factor limiting long-term use of peritoneal dialysis is the maintenance of the function of the peritoneum as a dialysis membrane. Impairment of the anatomical and functional integrity of the peritoneal membrane may be due to severe or recurrent peritonitis but, also, in patients without a history of peritoneal infection, presumably as a result of contact between the peritoneum and a bioincompatible dialysis solution. When investigating the structural and functional changes in the peritoneal membrane, considerable attention was given to cytokines. The main source of cytokines in the peritoneal cavity are macrophages, mesothelial cells, and fibroblasts. In peritoneal dialysis, cytokines play a role both in defense against the development of peritoneal infection and in the course of peritoneal infection. By virtue of their biological effects, cytokines may affect the permeability of the peritoneal membrane and, consequently, the efficacy of peritoneal dialysis. In addition, cytokines are released on contact of the peritoneum with the dialysis solution and may thus be made use of in biocompatibility studies. Changes of cytokine levels can be studied--when performing peritoneal dialysis in clinical practice--in the dialysis solution drained from the peritoneal cavity, in tissue cultures, and in animal experiments. The effects of cytokines are modified by the action of their soluble receptors and antagonists. Future studies are warranted to clarify the role of cytokine antagonists and their soluble receptors.

Biocompatible Materials↗
PubMed1999

[Type I and III procollagen in patients with abdominal aorta aneurysms].

BACKGROUND: Collagen and elastin are the basic building stones of the aortal wall. During the process of development of an aneurysm of the abdominal aorta (AAA) degradation and remodelling of elastin and collagen in the intercellular matrix of its wall occurs. The two main types of collagen in the aorta are collagens type I and III. During type I collagen synthesis the carboxyterminal propeptide of procollagen (PICP) is released and during synthesis and degradation of collagen type III the aminoterminal propeptide collagen III (PIIINP). The objective of the present work was to assess to what extent the two factors can be used to follow up metabolic processes in the AAA wal and in plasma in relation to the extent and symptomatology of AAA. METHODS AND RESULTS: Samples of venous blood and the AAA wall were examined using radioimmunoanalytical methods. PIIINP levels in venous blood were significantly higher (wall p < 0.01) in patients with AAA (n = 78) as compared with the control group (n = 15). The authors did not reveal a statistically significant difference between the levels of the two factors in the blood of patients with AAA of different extent and symptomatology. The PIIINP concentration in the AAA wal correlated significantly with its extent and symptomatology (wall p < 0.01). CONCLUSIONS: Evidence was provided of an enhanced metabolism of collagen type III in the AAA wal with predominant degradation in growing and symptomatic AAA. For complete evaluation of the importance of PICP and PIIINP plasma levels it will be necessary to follow up their dynamics in subjects with growing, small (< 5 cm) AAA.

Aged↗
PubMed1999

Plasma endothelin levels in patients with abdominal aortic aneurysms.

OBJECTIVES: endothelin 1,2 plays a significant role in the process of atherogenesis and vascular wall injury. The aim of this study was to assess whether plasma endothelin 1,2 levels were elevated in patients with large or symptomatic abdominal aortic aneurysms (AAAs). DESIGN: a prospective open study. MATERIALS AND METHODS: plasma endothelin 1,2 levels were measured in 65 consecutive patients with infrarenal aortic aneurysms and compared with the levels in 44 healthy volunteer controls. The data for abdominal aneurysm patients was analysed in four subgroups: (i) small aneurysms (<5 cm), (ii) large aneurysms (>/=5 cm), (iii) asymptomatic aneurysms and (iv) symptomatic aneurysms. Comparisons were made between endothelin 1,2 levels in aneurysm patients and controls and between the different aneurysm subgroups. RESULTS: a highly significant difference (p<0.0001) was found between aneurysm patients and controls. Patients with large aneurysms had significantly higher levels than patients with small aneurysms (p<0.01). There was no statistical difference in endothelin 1,2 levels between symptomatic and asymptomatic patients; however, the highest levels were found in large, symptomatic aneurysms and the lowest in small, asymptomatic aneurysms. CONCLUSIONS: plasma endothelin 1,2 is an endogenous marker of aneurysm diameter. Further studies are required to determine whether it relates to the rate of growth of aneurysms.

Aged↗
PubMed1998

Gastric lipoma presenting as upper gastrointestinal obstruction.

A 61-year-old man presented with an upper gastrointestinal obstruction caused by a submucosal gastric lipoma in the prepyloric area. The diagnosis was made coincidentally during his admission for another disease. Gastric resection was performed because of a large lipoma combined with florid gastric ulcers. The frequency of gastric lipoma, its differential diagnosis, means of diagnosis, and treatment are discussed.

Diagnosis, Differential↗
PubMed1998

[Cytokine metabolism in aneurysms of the abdominal aorta].

The main cytokines which participate in the etiopathogenesis of aneurysms of the abdominal aorta (AAA) are: tumour necrotizing factor (TNF), interleukins 1b, 2, 6 and 8 (IL 1b, 2, 6, 8), platelet growth factor (PDGF) and endothelin 1, 2 (ET 1, 2). The objective of the presented work was to assess whether plasma levels of these cytokines can be used as endogenous markers of the size and symptomatology of AAA and also to what extent they correlated with hypertension which is a serious risk factor of AAA. During the three-year period (1995-1997) 86 patients with AAA were examined. The control group (n = 30) was formed by patients admitted for planned cholecystectomy. Plasma levels of all investigated cytokines with the exception of IL 8 in AAA differed markedly from the levels in the control group (p < 0.05-p < 0.0001). Changes in levels of IL8 and ET 1, 2 were significant in relation to the size of AAA (p < 0.05 and p < 0.01 resp.). The IL8 levels together with TNF in hypertonic patients correlated with the size of the AAA (p < 0.05 and p < 0.01 resp.), in normotonic subjects with the levels of IL 1b and IL2 (p < 0.05). The TNF levels were significant in symptomatic AAA (p < 0.05). The rising or declining levels of some plasma cytokines can serve as plasma markers of the growth and symptomatology of AAA.

Adult↗
PubMed1996

[Initial results of monitoring hepatitis E virus antibodies in selected population groups in the West Bohemia Region. Preliminary report].

The authors examined sera of 269 subjects for the presence of antibodies against the hepatitis E virus. In the group of patients with acute hepatitis (after elimination of hepatitis A, B and C) antibodies were detected in 27.8%, in the group of gypsies with non-hepatic disease in 4.8%, in a group of venereological patients in 2.4%. The conclusions from the preliminary results confirm the circulation of the hepatitis E virus in our population and its importance in the etiology of liver disease, in particular in more advanced age groups.

Adolescent↗
PubMed1995

[Levels of endogenous plasma cortisol in patients with rheumatoid arthritis and other diffuse connective tissue diseases].

The authors tried to obtain information on levels of endogenous plasma cortisol in patients with rheumatoid arthritis and other diffuse connective tissue diseases, in particular systemic lupus erythematosus. Endogenous cortisol was assessed by radioimmunoanalysis at 8 a.m. and 4 p.m. If the sum of the morning and afternoon values reached the level of 280 nmol/l (sum of the lowest still normal values), they considered the daily cortisol secretion still normal. In a group of 30 patients who did not have glucocorticoid therapy the authors found only in one patient a lower daily endogenous cortisol secretion. In 117 patients with a relatively severe course of rheumatoid arthritis where small doses of corticoids (equivalents of 5-10 mg Prednisone) were administered for prolonged periods, a reduced daily secretion of endogenous plasma cortisol was recorded in almost 40%. Repeated examinations made in 13 subjects with rheumatoid arthritis revealed relatively frequent differences in values of endogenous plasma cortisol. In rare instances extremely low plasma levels of endogenous cortisol were found. Similar results as in rheumatoid arthritis, although assessed in a relatively small number of probands, were obtained by the authors also in patients with other diffuse connective tissue diseases, in particular those with systemic lupus erythematosus. Those patients had for prolonged periods roughly double doses of corticoids as compared with patients with rheumatoid arthritis. During repeated examinations the endogenous plasma cortisol levels varied also. The authors are aware that from the assembled results it is so far not possible to draw any definite conclusions and that further investigations are needed which will test the impact of endogenously produced corticoid.

Arthritis, Rheumatoid↗
PubMed1995

The serum level of endothelin in patients with hand-arm vibration syndrome.

The authors discuss the relationship of serum concentrations of endothelin in patients with vascular disease due to vibration and the severity of the disease; the highest concentrations were found in the most advanced forms of disease. Combination of the vascular disease due to vibration with complicating cardiovascular diseases is also discussed. The authors prepared methodical norms for the elaboration and evaluation of the results of serum concentrations of endothelin. These norms are useful for comparing studies in various regions and for international cooperation. The paper presents preliminary results so far of small group of patients. The examination could be a useful additional method for the classification and assessment of severity and prognosis of the disease.

Adult↗
PubMed1994

[Hepatitis C antibodies in health personnel].

Using the second generation test, the authors examined 320 health professionals of the Faculty Hospital in Plzen and dialyzation centres in Karlovy Vary and Sokolov for the presence of antibodies against the hepatitis C virus. Antibodies were detected in 7 of them (2.2%). Serum positivity was confirmed only in paramedical workers, the highest herd immunity was recorded in workers in the dialyzation centre in Plzen. The authors evaluate the prevalence of antibodies in relation to age and period of practice in the health services.

Adult↗
PubMed1993

[Significance of the stress score in patients with coronary artery disease].

The authors tested the importance of the load score for assessment of the prognosis of patients after myocardial infarction and for assessment of the severity of the atherosclerotic affection of the coronary arteries. The score is a numerical value calculated from data assembled during evaluation of bicycle ergometry according to the following formula: total duration of the load-(5X deviation of ST)-(4X anginous index). The value of the load score was retrospectively tested in a group of 31 patients after myocardial infarction (mean age 58.1 years), who died during the subsequent five years, and in 64 subjects, mean age 50.1 years, who were subjected to coronarography. The value of the load score in 77.4% of the group who died was less than -10. In the group of patients subjected to coronarography where three arteries or the trunk of the left coronary artery was affected the score in 81.8% of the patients was smaller than -10. The authors proved a close correlation between the value of the load score and the severity of affection of the coronary arteries. Therefore the load score can be used as one of the factors when selecting patients for coronarographic examination and revascularization of the heart muscle. The lead score helps also in the estimation of the prognosis after myocardial infarction.

Coronary Vessels↗
PubMed1993

[Hormonal changes in open-angle glaucoma. I. Levels of immunoreactive insulin in serum].

This paper deals with the relation of disorders of carbohydrate metabolism to etiopathogenesis of glaucoma. 102 patients with primary glaucoma of an open angle were examined and it was discovered that 80 patients from this group (78%) had an abnormal immuno-reactive insulin curve, in particular of the hypersecretory type. Standard gauge test for abnormal glucose level was administered with 31 glaucomatous patients (30%). From this point of view screening for immuno-reactive insulin is a more sensitive and reliable method than the glucose standard gauge test. It is recommended that testing for immuno-reactive insulin should be introduced for all glaucomatous patients because this can help both in the detection of early stages of diabetes and in the administration of primary prevention of atherosclerosis among the population.

Adult↗
PubMed1993

[Hormonal changes in open-angle glaucoma. II. Levels of cortisol and somatotropin in serum].

Observing interrelation between carbohydrate metabolism disorders and contrainsular mechanisms in a group of 102 glaucomatous patients, a higher level of cortisol in plasma was detected in 40.2% of glaucomatous patients of whom 31% had increased levels of cortisol together with IRI. In isolation the increased level of cortisol occurred in 8.9%. The frequency of increased cortisol level in glaucomatous patients is substantially lower (40.2%) than the frequency of abnormal insulin curves (78%). Increased levels of growth hormone in the group of patients occurred in 9.3% of cases and these were almost always associated with an abnormal immuno-reactive insulin curve (IRI curve). Accordingly, it is evident that hormonal disorders are a major factor in the onset of both diabetes and glaucoma.

Adult↗
PubMed1992

[Personal experience with the care of children and adolescents at risk for ischemic heart disease].

Children and adolescents with hereditary disposition for ischemic heart disease form a substantial part of the clients of preventive cardiological surgeries for children. The authors present their results and experience they assembled by monitoring and supervising these subjects for a five-year period. During the initial examination they found in these subjects, as compared with controls, a more frequent prevalence of habits dangerous with regard to the genesis and development of ischaemic heart disease and deviations in the lipid metabolism with an atherogenic character. Arterial hypertension and protracted insulin secretion were also more frequent. The collaboration with their parents as regards adherence to a regime and therapeutic provisions was very satisfactory. After five years' supervision in children and adolescents with hereditary disposition for ischaemic heart disease the prevalence of obesity, arterial hypertension and abnormalities of blood lipid levels declined significantly. The above measures had the least effect on the impaired insulin secretion.

Adolescent↗