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Biomedical subjects

J Kvasnicka

Publications and source records attributed to J Kvasnicka.

At least 19 recordsLinked to original sources
PubMed2007

Impaired microvascular reactivity and endothelial function in patients with Cushing's syndrome: influence of arterial hypertension.

The aim of the study was to evaluate skin microvascular reactivity (MVR) and possible influencing factors (fibrinolysis, oxidative stress, and endothelial function) in patients with Cushing's syndrome. Twenty-nine patients with active Cushing's syndrome (ten of them also examined after a successful operation) and 16 control subjects were studied. Skin MVR was measured by laser Doppler flowmetry during post-occlusive (PORH) and thermal hyperemia (TH). Malondialdehyde and Cu,Zn-superoxide dismutase were used as markers of oxidative stress. Fibrinolysis was estimated by tissue plasminogen activator (tPA) and its inhibitor (PAI-1). N-acetyl-beta-glucosaminidase, E-selectin, P-selectin, and ICAM-1 were used as markers of endothelial function. Oxidative stress and endothelial dysfunction was present in patients with hypercortisolism, however, increased concentration of ICAM-1 was also found in patients after the operation as compared to controls (290.8+/-74.2 vs. 210.9+/-56.3 ng.ml(-1), p<0.05). Maximal perfusion was significantly lower in patients with arterial hypertension during PORH and TH (36.3+/-13.0 vs. 63.3+/-32.4 PU, p<0.01, and 90.4+/-36.6 vs. 159.2+/-95.3 PU, p<0.05, respectively) and similarly the velocity of perfusion increase during PORH and TH was lower (3.2+/-1.5 vs. 5.2+/-3.4 PU.s(-1), p<0.05, and 0.95+/-0.6 vs. 1.8+/-1.1 PU.s(-1), p<0.05, respectively). The most pronounced impairment of microvascular reactivity was present in patients with combination of arterial hypertension and diabetes mellitus.

Adult↗
PubMed2006

Biochemical markers of endothelial dysfunction in patients with endocrine and essential hypertension.

The aim of our study was to evaluate potential differences in the concentration of biochemical markers of endothelial dysfunction between essential hypertension, endocrine hypertension (pheochromocytoma, primary hyperaldosteronism) and control healthy group and to assess a potential relationship between these markers of endothelial dysfunction and vasopressor substances overproduced in endocrine hypertension. We have investigated 21 patients with moderate essential hypertension, 29 patients with primary hyperaldosteronism, 24 subjects with pheochromocytoma and 26 healthy volunteers. Following parameters of endothelial dysfunction were measured, von Willebrand factor (vWf), plasminogen activator (t-PA) and E-selectin (E-sel). Clinical blood pressure was measured according to the European Society of Hypertension recommendations. We found significantly higher levels of the von Willebrand factor in patients with essential hypertension in comparison with a control group (114+/-20 IU/dl vs 90+/-47 IU/dl; P=0.04) and patients with primary hyperaldosteronism (114+/-20 IU/dl vs 99+/-11 IU/dl; P=0.01). Patients with endocrine hypertension revealed increased levels of vWF compared to the control group, but these differences did not reach statistical significance. Levels of t-PA were increased in patients with pheochromocytoma in comparison with the control group (4.6+/-1.9 ng/ml vs 3.4+/-0.9 ng/ml; P=0.01) and with primary hyperaldosteronism (4.6+/-1.9 ng/ml vs 3.4+/-1.1 ng/ml; P<0.01). In case of E-selectin we found lower levels in patients with pheochromocytoma in comparison with other groups, but they differed significantly only with primary hyperaldosteronism (40.2+/-15.0 ng/ml vs 51.3+/-23.0 ng/ml; P=0.05). Our study did not reveal any convincing evidence of differences in the levels of biochemical markers of endothelial dysfunction between essential and endocrine hypertension. No correlation between the biochemical markers of endothelial dysfunction and vasopressor substances activated in endocrine hypertension was found.

Adrenal Gland Neoplasms↗
PubMed2006

[Transpupillary thermotherapy in the treatment of choroidal neovascularization in age-related macular degeneration--one year's results].

THE AIM OF THE STUDY: Authors refer to one year's results of the study of 56 eyes of 50 patients with the exsudative form of the age-related macular degeneration treated by means of transpupillary thermotherapy at the Department of Ophthalmology, School of Medicine, Charles University, Hradec Králové (Königgrätz), Czech Republic, EU. PATIENTS AND METHODS: In all patients, the best-corrected visual acuity (BCVA) before treatment was established. Beside the ordinary examination methods, the digital color photography of the fundus with topography of the lesion, fluoresceine angiography (FAG), or possibly indocyanine green angiography and optical coherence tomography (OCT) were performed. After the treatment, in given intervals, the BCVA was established, and retinal findings were evaluated by means of biomicroscopic examination, comparative color photography of the fundus, optical coherence tomography, fluoresceine angiography, or possibly indocyanine green angiography. RESULTS: During one year after the treatment, the visual acuity decreased by 2 or more lines on Snellen optotypes in 38.2% of patients, remained stable in 52.9%, and improved in 8.8% of patients. The FAG findings improved in 83.9% and the OCT findings in 84.8% of patients. This improvement was statistically significant. In patients with classical choroidal membrane, the BCVA decreased in 35.8%, remained stable in 57.1% and improved in 7.1% of patients. The FAG finding improved in 78.7%, and the OCT finding improved in 90.8% of patients. The improvement of the OCT findings was statistically significant. In patients with occult choroidal membrane, the visual acuity decreased in 45 %, remained stable in 45%, and improved in 10% of patients. The FAG findings improved in 88.9%, and the OCT findings in 78.9% of patients. The improvement was statistically significant. CONCLUSION: Our results show that transpupillary themotherapy belongs to important methods of treatment of the classical and occult membranes of the choroid in exsudative forms of the ARMD.

Aged↗
PubMed2005

[Computer program for antiglaucomatous surgeries analysis].

Computer analysis of long-term results of the surgical treatment of glaucoma needs suitable program for database data download retrospectively and prospectively as well. We composed a universal database program Glaucoma Access 97 for patients' follow-up in glaucoma surgery centers. Data about 1073 antiglaucomatous filtering surgeries from the period 1990-2000 were downloaded. The program permits to download data about the patients before the surgery, details about the operation procedure, and from the follow-up visits into the database using special software questionnaire sheets. Outcome from the database may be data about long-term IOP compensation, visual acuity changes, and treatment after the surgery. Evaluation of the data allows to follow up the successfulness of the treatment of specified groups of patients and to compare results of surgeons and individual departments as well.

Databases as Topic↗
PubMed2005

[Electroretinoraphic findings in age-related macular degeneration (ARMD) before and after radiotherapy].

Standard ERG examinations were performed in 61 patients with ARMD before and after radiotherapy. Before the radiotherapy, a significant decrease in the cone b- wave amplitude and a significant reduction of the sum of oscillatory potentials (OP1-OP4) were found. At 24 months after the first dose of radiotherapy, a significant decrease in the rod response and 30-Hz flicker response were described. A possible explanation for the findings is an influence of radiotherapy onto primary circulatory disturbances in the whole retina in ARMD.

Aged↗
PubMed2005

[Results of cataract surgery in patients aged 80 years and older].

BACKGROUND: The authors evaluate the benefits of the cataract surgery in old patients. METHODS AND RESULTS: Best corrected visual acuity (BCVA) before operation, on the first postoperative day and 6 months after surgery were assessed as well as changes in the quality of life using the modified test VF-8. The positive effect of the cataract surgery was proved in patients in this age group. Not only recovery of the visual functions, but also improvement of the orientation and of the quality of life was reported by those patients. CONCLUSIONS: Based on our results we consider the cataract surgery indicated for old patients even with systemic morbidities.

Aged, 80 and over↗
PubMed2005

[Pulmonary veins and atrial fibrillation: a pathological study of 100 hearts].

Pathogenesis of atrial fibrillation (AF), the most common sustained heart arrhythmia, is not yet fully elucidated. Recent electrophysiological studies have shown that in most patients with AF the arrhythmia is triggered by ectopic beats originating from extensions of left atrial myocardium over the pulmonary veins (PVs), so called myocardial sleeves (MSPV). A total of 100 hearts (393 PVs) obtained at autopsy were prospectively studied - 50 from patients with chronic AF (average age 76.9 +/- 7.3 yrs.) and a control group of 50 with a sinus rhythm (aver. age 71.7 +/- 9.5 yrs.). This is a largest study published on this topic so far. It appeared that MSPV frequently harbour pathological lesions, particularly senile atrial amyloid, and scarring. These two pathological changes were evaluated semiquantitatively on a grade 0-3 basis in individual PVs, comparing the results in the AF vs. the control group. Amyloidosis of MSPV was found in 68 % of all hearts and in 55 % of all sleeves. The deposits were most marked in the right superior PV. Amyloidosis was more frequent and more severe in MSPV of patients with AF (58.5 %; average grade 0.89) than of those without AF (51.7 %; aver. grade 0.76); the differences, however, lack statistical significance. Scarring of MSPV was present in all 349 sleeves, more markedly in the left inferior, left superior, and right superior PVs. It was significantly more severe in patients with AF compared to those without the arrhythmia. By an injection metod, we have shown that MSPV are supplied by coronary arteries. However, the degree of scarring of the sleeves did not correlate with the degree of coronary atherosclerosis. We suggest that genesis of the scarring is not postnecrotic but degenerative, due to diffuse hypoxia of the sleeve myocardium. To conclude, amyloidosis and particularly scarring of MSPV appear generally in the elderly population as an arrhythmogenic substrate for AF.

Aged↗
PubMed2003

Increase of inflammatory state in overweight adults with combined hyperlipidemia.

BACKGROUND AND AIM: Elevated levels of acute phase reactants are found in patients with cardiovascular disease. It is suggested that adipose tissue is a determinant of a low level of inflammatory state in overweight persons. The aim of the study was to determine, whether combined hyperlipidemia, which is an important factor of atherosclerosis, has influence on the inflammatory response in overweight adults. METHODS AND RESULTS: Levels of soluble cell adhesion molecules sICAM-1, sE-selectin and sP-selectin, PAI-1 Ag (by Elisa test), orosomucoid (ORM) and transferrin (TRF) (by microturbidimetry) and fibrinogen (FBG) according to Clauss were examined in peripheral blood of overweight adults (n 33, body mass index 27.1 +/- 1.8 kg/m2) with combined hyperlipidemia and in equal numbers of age, sex and BMI matched non-hyperlipidemic group. Overweight adults with combined hyperlipidemia had significantly higher plasma levels of sICAM-1 (376.5 +/- 107.4 ng/mL vs 239.3 +/- 60.4 ng/mL; p < 0.001), sE-selectin (70.4 +/- 20.2 ng/mL vs 48.5 +/- 25.6 ng/mL; p = 0.005), sP-selectin (228.2 +/- 88.6 ng/mL vs 123.1 +/- 45.3 ng/mL; p < 0.001) and positive acute phase proteins ORM (0.82 +/- 0.16 g/L vs 0.64 +/- 0.20 g/L; p = 0.005), FBG (3.42 +/- 0.54 g/L vs 2.74 +/- 0.57 g/L; p = 0.037) and PAI-1 Ag (97.9 +/- 40.6 ng/mL vs 56.4 +/- 25.6 ng/mL; p < 0.05), and a decrease of negative acute phase protein TRF (2.14 +/- 0.40 g/L vs 2.77 +/- 0.45 g/L; p < 0.001) compared to the results in overweight non-hyperlipidemic controls. CONCLUSIONS: It is suggested that overweight adults have an increase of inflammatory response dependent on hyperlipidemia. It was apparent from the elevation of sE--selectin, sP--selectin and sICAM-1 and from an increase of systemic inflammatory response according to the increase of "positive" acute phase proteins (APRs) and the decrease of "negative" APR protein levels in these patients.

Acute-Phase Proteins↗
PubMed2003

Homocystinuria due to cystathionine beta-synthase deficiency: novel biochemical findings and treatment efficacy.

To explore the pathogenesis of cystathionine beta-synthase (CBS) deficiency and to test the efficacy of pharmacological therapy we examined a panel of metabolites in nine homocystinuric patients under treated and/or untreated conditions. Off pharmacological treatment, the biochemical phenotype was characterized by accumulation of plasma total homocysteine (median 135 micromol/L) and blood S -adenosylhomocysteine (median 246 nmol/L), and by normal levels of guanidinoacetate and creatine. In addition, enhanced remethylation was demonstrated by low serine level (median 81 micromol/L), and by increased concentration of methionine (median 76 micromol/L) and N -methylglycine (median 6.8 micromol/L). Despite the substantially blocked transsulphuration, which was evidenced by undetectable cystathionine and severely decreased total cysteine levels (median 102 micromol/L), blood glutathione was surprisingly not depleted (median 1155 micromol/L). In 5 patients in whom pharmacological treatment was withdrawn, the differences of median plasma total homocysteine levels (125 micromol/L after withdrawal versus 33 micromol/L under treatment conditions), total cysteine levels (139 versus 211 micromol/L) and plasma serine levels (53 versus 103 micromol/L) on and off treatment demonstrated the efficacy of long-term pyridoxine/betaine administration ( p <0.05). The treatment also decreased blood S -adenosylhomocysteine level (133 versus 59 nmol/L) with a borderline significance. In summary,our study shows that conventional treatment of CBS deficiency by diet and pyridoxine/betaine normalizes many but not all metabolic abnormalities associated with CBS deficiency. We propose that the finding of low plasma serine concentration in untreated CBS-deficient patients merits further exploration since supplementation with serine might be a novel and safe component of treatment of homocystinuria.

Adolescent↗
PubMed2003

[Duo-Bonharen--a new viscoelastic preparation. Experimental study].

The paper discusses preclinical tests of a new viscoelastic preparation for ophthalmosurgery. Experiments revealed that preparation Duo-Bonharen which contains hyaluronic acid prepared by bacterial fermentation is suited for clinical tests. After a 24-hour interval following administration into the anterior chamber it does not raise intraocular pressure. In experiments it has no side-effects on the eye. The dispersed form in a higher concentration (5%) adheres very well to ocular tissues and protects them adequately during surgery. The cohesive form in an optimal concentration (1.5%) can be rapidly removed from inside the eye. The properties of Duo-Bonharen in experiments are comparable with similar viscomaterials which are used. The new viscoelastic material Duo-Bonharen appears suitable for clinical tests in particular for cataract surgery.

Animals↗
PubMed2003

[Corneal surface analysis].

Fourier analysis is a powerful method of evaluating the surface of the cornea. In 50 patients after photorefractive keratectomy included in our study we measured spherical equivalent, regular astigmatism, irregular astigmatism and decentration retrospectively acquired by Fourier series analysis of corneal topography data 1, 3, 6 and 12 months after operation. Postoperative decentration increased significantly from a mean preoperative value. The preoperative and postoperative values are not significantly different. The Fourier spherical equivalent and the values of keratometric spherical (equivalent) are highly correlated. Correlation among decentration, irregular astigmatism and best corrected visual acuity is important for clinical practice. Due to Fourier analysis we obtain information, which could explain worse results of some surgeries.

Astigmatism↗
PubMed2003

[Soluble adhesion molecules in female patients with breast carcinoma].

BACKGROUND: Serum levels of some soluble adhesion molecules (e.g. ICAM-1, or E-selectin) are higher in some patients with breast cancer (especially metastatic) compared to controls. They bring about the increased risk of developing metastases and they can negatively influence the prognosis of patients. The aim of our study was to assess the serum levels of several soluble adhesion molecules (soluble E-selectin, P-selectin, ICAM-1, VCAM-1 and CD44s) in patients with breast cancer in clinical stage 0-IV before the beginning of hormonal therapy and/or chemotherapy. We wanted to find out if these parameters differ between various stages of breast cancer and if their levels are influenced by the therapy. METHODS AND RESULTS: We examined 59 mostly postmenopausal patients with breast cancer in clinical stage 0-IV (mean age was 62 years). One patient was in stage 0, 10 patients were in stage I, 24 patients were in stage IIA, 11 patients were in stage IIB, 5 patients were in stage III and 8 patients were in stage IV. Serum levels of soluble E-selectin, P-selectin, ICAM-1, VCAM-1 and standard form of CD44 were assessed using ELISA in sera of patients with breast cancer before the institution of hormonal therapy and/or chemotherapy and 3 and 12 months after the beginning of therapy. Compared to controls, patients with (metastatic and also non-metastatic) breast cancer before the beginning of therapy had higher serum levels of soluble E-selectin, P-selectin, ICAM-1 and standard form of CD44. Serum levels of E-selectin, ICAM-1 and also VCAM-1 significantly decreased one year after the beginning of therapy. Serum levels of soluble adhesion molecules mutually correlated and they also correlated with serum levels of soluble TNF and IL-2 receptors and some acute phase proteins (CRP and orosomucoid). CONCLUSIONS: Serum levels of some soluble adhesion molecules (E-selectin, P-selectin, ICAM-1 and CD44s) were higher in some patients with breast cancer and decreased again after hormonal therapy and/or chemotherapy. Only larger studies with longer follow-up may imply if any of these parameters (e.g. soluble P-selectin), or their combination may become useful marker of activity and/or outcome.

Adult↗
PubMed2003

[Ocular subclinical changes in significant carotid stenosis].

58 patients (40 men, 18 women) affected by high-grade carotid stenosis were examined using automated perimetry and electroretinography. Patients' ages ranged from 53 to 83 years with a mean of 67 years. We examined 29 patients with unilateral and 29 patients with bilateral symptomatic stenosis of carotid arteries and cerebrovascular alterations, without ocular changes. Visual field defects were found by 41 patients (70.6%), by 51.3% patients there were mild or middle defects, by 48.7% hard defects. The results using electroretinography showed significant amplitude decrease and prolonged latencies of the oscillatory potentials on ipsilateral side in unilateral cases. Significant decrease of amplitudes OP2 in patients after the attack of amaurosis fugax has been observed too. The critical value of this amplitude was estimated to 37 muV. High-grade stenosis of carotid arteries are accompanied by visual field defects and electric retinal functions disorders at the time when objective finding on the fundus is normal. The cause of these disorders might be decreased arterial perfusion or microembolization. The perimetry and ERG findings didn't correlate, nevertheless both tests can be useful for detection of early retinal alterations and represent a help-method to determine indications for carotid endarterectomy.

Aged↗
PubMed2003

[Acute phase proteins in female patients with breast carcinoma].

BACKGROUND: Serum levels of C-reactive protein (CRP) and orosomucoid are increased in more than one half of patients with metastatic breast cancer. The information concerning their levels in non-metastatic breast cancer is inconclusive. The aim of our study was to examine some acute phase proteins (CRP, orosomucoid, prealbumin, alpha 2-macroglobulin and transferrin) in patients with various clinical stages of breast cancer before hormonal and/or chemotherapy and 3 and 12 months after its institution and to assess the influence of their levels on the outcome of patients. METHODS AND RESULTS: Altogether 59 women with breast cancer in clinical stage 0-IV, median age 62 years (47 of them after menopause) were examined. One patient was in stage 0, ten patients in stage I, 24 patients in stage IIA, 11 patients in stage IIB, five patients in stage III and eight patients in stage IV. Acute phase proteins (CRP, orosomucoid, transferrin, prealbumin and alpha 2-macroglobulin) were examined in the sera samples using microturbidimetry. Serum levels of CRP and orosomucoid were higher in patients with breast cancer in all stages compared to controls. Serum levels of CRP (resp. of orosomucoid) higher than mean +2 SD had 30.5% (resp. 39%) of patients with breast cancer. One year after the beginning of therapy serum levels of CRP and orosomucoid significantly decreased, however, in case of orosomucoid they remain higher compared to controls. Serum levels of CRP and orosomucoid correlated before therapy in patients with breast cancer one to another and also with serum levels of soluble TNF (tumour necrosis factor) receptor type I and soluble ICAM-1. IN CONCLUSION: Patients with breast cancer before hormonal therapy and/or chemotherapy had compared to controls increased serum levels of CRP and orosomucoid, however, there was no difference between stages I-III. Observed correlation between serum levels of CRP and soluble TNF receptors suggests the important role of proinflammatory cytokines in stimulating their hepatic synthesis also in patients with breast cancer. Putative prognostic role of persistently increased levels of orosomucoid in patients with non-metastatic breast cancer warrants further investigation.

Acute-Phase Proteins↗
PubMed2003

[Laboratory indicators of endothelial involvement in rheumatic diseases associated with vasculitis in children].

BACKGROUND: Endothelial activation is an important etiopathogenetic factor in a group of disorders characterised by primary or secondary vasculitis. The aim of our study was to determine blood concentrations of von Willebrand factor (vWF), vypustĕno soluble intercellular adhesion molecule-1 (ICAM-1) and E-selectin (E-sel) in children with various rheumatic diseases and in paediatric controls and to correlate them with clinical and laboratory variables. METHODS AND RESULTS: Total of 28 healthy children (ZD) and 48 patients were evaluated: 6 with systemic lupus erythematosus (SLE), 7 with other diffuse connective tissue diseases (SSD), 11 with Henoch-Schönlein purpura (HSP), 14 with oligoarticular juvenile idiopathic arthritis (JIA) and 10 febrile controls (FC). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and full blood count were recorded. ICAM-1, E-sel and vWF concentrations were measured by sandwich ELISA kits. In SLE patients' concentrations of vWF and ICAM-1 were significantly higher than in healthy (p < 0.05), but not febrile controls. ICAM-1 was significantly increased also in SSD group when compared to healthy children (p < 0.01). Differences in other groups did not reach statistical significance. Significant negative correlation with age was observed for the group as a whole, E-sel correlated with leukocyte and thrombocyte counts (p < 0.01), both molecules with CRP (p < 0.05) and with each other (p < 0.01). CONCLUSIONS: Combined measurement of vWF, ICAM-1 and E-sel as possible markers of endothelial activation in such vypustĕno wide spectrum of paediatric patients and controls is unique vypustĕno. Our finding of increased concentrations of vWF and/or ICAM-1 in children with systemic autoimmune diseases underlines the importance of endothelial involvement in these disorders, but their predictive value in the disease monitoring needs to be further studied.

Adolescent↗
PubMed2003

Tissue factor, tissue factor pathway inhibitor and cytoadhesive molecules in patients with an acute coronary syndrome.

The tissue factor plays a crucial role in initiating blood coagulation after plaque rupture in patients with acute coronary syndrome. It is abundant in atherosclerotic plaques. Moreover, P-selectin, some cytokines, endotoxin and immune complexes can stimulate monocytes and induce the tissue factor expression on their surface. The aim of the study was to compare plasma levels of the tissue factor, tissue factor pathway inhibitor, P-selectin, E-selectin and ICAM-1 in patients with acute myocardial infarction, unstable angina pectoris, stable coronary artery disease and normal control subjects. In addition, plasma levels of the tissue factor, tissue factor pathway inhibitor, P-selectin, E-selectin and ICAM-1 were measured in the blood withdrawn from the coronary sinus in a subgroup of patients with unstable angina pectoris and stable coronary artery disease in which the difference between concentrations in the coronary sinus and systemic blood was calculated. A significant increase in tissue factor pathway inhibitor plasma levels was detected in patients with acute myocardial infarction (373.3+/-135.1 ng/ml, p<0.01) and unstable angina pectoris (119.6+/-86.9 ng/ml, p<0.05) in contrast to the patients with stable coronary artery disease (46.3+/-37.5 ng/ml) and normal subjects (45.1+/-14.3 ng/ml). The plasma levels of tissue factor pathway inhibitor were significantly increased both in the coronary sinus and systemic blood in the patients with unstable angina pectoris. There was only a non-significant trend to higher plasma levels of the tissue factor in patients with acute myocardial infarction and unstable angina pectoris as compared to the patients with stable coronary artery disease and normal subjects, the values being 129.1+/-30.2 pg/ml, 130.5+/-57.8 pg/ml, 120.2+/-45.1 pg/ml and 124.9+/-31.8 pg/ml, respectively. Plasma levels of soluble P-selectin was only slightly, but non-significantly higher in patients with unstable angina pectoris and stable coronary artery disease (184.2+/-85.4 ng/ml and 201.6+/-67.9 ng/ml, respectively) than in patients with the acute myocardial infarction (157.4+/-88.4 ng/ml) or normal subjects (151.4+/-47.1 ng/ml). The difference in plasma levels of soluble ICAM-1 between the blood withdrawn from the coronary sinus and systemic circulation correlated significantly with the corresponding difference in plasma levels of soluble P-selectin and E-selectin. In conclusion, the tissue factor and the tissue factor pathway inhibitor play a crucial role in the initiation of arterial thrombosis. The tissue factor pathway inhibitor levels are increased both in the systemic blood and in the coronary sinus of patients with the acute coronary syndrome.

Adult↗