Biomedical subjects

J Kvasnicka

Publications and source records attributed to J Kvasnicka.

At least 55 records · Page 3Linked to original sources

PubMed2001

[Changes in serum levels of C-reactive protein and the soluble adhesion molecules, sE-selectin and sICAM-1, after transdermal 17-beta estradiol replacement].

OBJECTIVE: Increases in serum concentrations of C-reactive protein (CRP) and soluble adhesion molecules sE-selectin and sICAM-1 are regarded as risk factors of atherosclerosis now. We aimed to analyse an effect of estrogen replacement therapy (ERT) by transdermal 17-beta estrogen on the variables. DESIGN: A clinical study. SETTING: Division of Gynaecology and Obstetrics, Hospital, Jicín and Department of Gynaecology and Obstetrics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. METHODS: Serum concentrations of CRP (by immunoturbidimetry) and sE-selectin and sICAM-1 (both by ELISA test) were examined in 19 women (median age 50.0 years) after hysterectomy with both side adnexectomy before and after 4 months of continuous transdermal substitution by 17-beta estradiol (ERT) in 1.5 mg dose daily. Data were compared by paired t-test or by Wilcoxon test. P = 0.05, or below was taken as significant. RESULTS: Serum concentration of C-reactive protein was decreased in treated women after 4 months of ERT (before ERT 1.82 +/- 2.20 mg/l, after 4 months of ERT 0.28 +/- 0.55 mg/l; p = 0.006) as well as both soluble adhesion molecules: sE-selectin (before ERT 45.13 +/- 17.3 micrograms/l, after 4 months of ERT 31.39 +/- 9.03 micrograms/l; p = 0.027) and sICAM-1 (before ERT 271.84 +/- 62.30 micrograms/l, after 4 months of ERT 242.86 +/- 62.32 micrograms/l; p = 0.026). CONCLUSION: Transdermal substitution with 17-beta estradiol may reduce one of risk factor of atherogenesis in treated women after hysterectomy with both side adnexectomy.

Administration, Cutaneous↗

PubMed2001

Atherogenesis markers in patients with chronic rejection of renal allografts.

Patients with renal insufficiency are thought to be at the higher risk of atherosclerosis complications. In the present study we evaluated some atherogenesis risk factors in patients with biopsy proven chronic vascular rejection of transplanted kidney and compared them with matched groups of transplant recipients. Patients with chronic rejection had higher plasma levels of alfa-I-acid glycoprotein and fibrinogen as well as soluble P-selectin level. Surprisingly we found no differences in other adhesion molecules. In conclusion, patients with chronic renal graft rejection are at the higher risk of atherosclerosis development.

Acute-Phase Proteins↗

PubMed2001

[PRK and LASIK in patients with myopia ranging from -6 to -9 D] ].

OBJECTIVE: Observing of effectiveness, safety and short-term stability of patients with myopia ranging from -6.0 to -9.0 diopters (D) after surgery and their comparison. PARTICIPANTS AND METHOD: We were retrospectively analyzing pre- and postoperative outcomes of patients with myopia ranging from -6.0 to -9.0 D. 90 eyes were examined before laser in situ keratomileusis (LASIK) with mean spherical equivalent refraction -7.64 +/- 0.84 D and mean cylinder -1.23 +/- 1.1 D. 56 eyes were examined before photorefractive keratectomy (PRK) with mean spherical equivalent refraction -6.92 +/- 0.72 D and mean cylinder -0.60 +/- 0.55 D. Patients were examined before operation, one week, one month, three months, six months, nine months and one year after operation. Data were collected and analyzed by the computer programme. RESULTS: We observed the patients who underwent the operation and six months after surgery we received following results: After PRK mean spherical equivalent refraction was -0.23 +/- 1.24 D, mean cylinder -0.83 +/- 0.42 D, uncorrected visual acuity (UCVA) 0.86 +/- 0.35, best spectacle-corrected visual acuity (BCVA) 1.13 +/- 0.33. After LASIK mean spherical equivalent refraction was -0.29 +/- 1.19 D, mean cylinder -1.14 +/- 0.77 D, UCVA 0.65 +/- 0.25, BCVA 0.83 +/- 0.25. One year after PRK mean spherical equivalent refraction was -0.44 +/- 1.26 D, mean cylinder -0.80 +/- 0.57 D, UCVA 0.81 +/- 0.31, BCVA 0.97 +/- 0.21. After LASIK mean spherical equivalent refraction was -0.14 +/- 0.86 D, mean cylinder -1.26 +/- 0.89 D, UCVA 0.75 +/- 0.25, BCVA 0.89 +/- 0.20. CONCLUSIONS: Both methods are effective and their results after 3 to 6 months after laser treatment in patients with myopia ranging from -6.0 to -9.0 D were comparable. Based on the complex evaluation, we prefer LASIK nowadays.

Adult↗

PubMed2001

[Changes in the quality of life after cataract surgery].

The questionnaire VF-14 is one of the most frequently used methods for exploration of patients' subjective evaluation of cataract surgery outcomes. In this study, the answers of 349 patients' were evaluated. These respondents completed the questionnaires before cataract surgery and again after 6 months. When the postoperative questionnaires were filled-in, 196 respondents had one eye operated on (group A), and 153 had both eyes operated on (group B). All cataract surgeries were performed by phacoemulsification. The complication--rupture of the posterior capsula--occured in 0.8%. In 26.7% patients an accompanying secondary eye disease was found. The average VF-14 index was 63.5 (SD 21.32) in group A and 59.4 (SD 22.62) in group B. After the surgery the VF-14 index increased significantly--in group A was the average 80.6 (SD 20.47) and in group B even higher 87.2 (SD 16.14). The change of VF-14 index prior to and after the operation was proven to be statistically significant both in group A and in group B (p < 0.001). The improvement of the VF-14 index was found in group A in 80.6% and in group B in 88.9% of respondents. The patients' satisfaction with their vision after cataract surgery was highly increased. The outcomes of the questionnaire study document the high success rate of cataract surgery for patients.

Aged↗

PubMed2001

Increasing plasma levels of soluble cell adhesion molecules (sE-Selectin, sP-Selectin and sICAM-1) in overweight adults with combined hyperlipidemia.

Combined hyperlipidemia (coincident present hypercholesterolemia and hypertriglyceridemia) may contribute to the development of atherosclerosis and coronary artery disease by increasing of cell adhesion molecules (CAMs). Although the cellular expression of CAMs is difficult to assess clinically, soluble forms of CAMs (sCAMs) are present in the circulation and may serve as marker of CAMs. The aim of this study was to determine whether combined hyperlipidemia in overweight adults without clinical evidence of cardiovascular disease, diabetes mellitus or hypertension is associated with increased expression of CAMs. We examined the levels of soluble cell adhesion molecules (sICAM-1, sE-Selectin and sP-Selectin) in blood plasma of overweight adults (n = 36), mean of BMI 27.08 +/- 4.12 kg/m2 with combined hyperlipidemia, with total cholesterol (TC) 7.27 +/- 1.50 mmol/l, LDL cholesterol 4.89 +/- 1.35 mmol/l, HDL cholesterol 1.27 +/- 0.51 mmol/l and triglycerides (TG) 4.08 +/- 2.22 mmol/l before lipid-lowering therapies, and in equal numbers of age, sex and BMI matched controls. Patients with combined hyperlipidemia had significantly higher plasma levels of soluble intercellular adhesion molecule-1 (sICAM-1) (298.13 +/- 41.24 ng/ml versus 241.35 +/- 37.48 ng/ml; P < 0.001), sE-Selectin (63.31 +/- 9.48 ng/ml versus 42.16 +/- 14.18 ng/ml; P < 0.001) and sP-Selectin (161.18 +/- 20.85 ng/ml versus 111.54 +/- 26.12 ng/ml; P < 0.001) compared with overweight, non-hyperlipidemic control subjects. Combined hyperlipidemia in adults with overweight is associated with elevated soluble plasma levels of CAMs. We suppose that levels of CAMs in these patients may be determined as a marker for appreciation of their potential atherosclerotic burden.

Arteriosclerosis↗

PubMed2000

Increase of adhesion molecules, fibrinogen, type-1 plasminogen activator inhibitor and orosomucoid in growth hormone (GH) deficient adults and their modulation by recombinant human GH replacement.

OBJECTIVE: GH deficiency (GHD) is usually associated with a higher incidence of cardiovascular disease (CVD). The aim of this study was to establish whether patients with GHD, like those with CVD, show an increase in fibrinogen (FBG), type-1 plasminogen activator inhibitor (PAI-1), acute phase response proteins (APR), and soluble adhesion molecules. The effect of recombinant human GH (rhGH) replacement, on these parameters was also investigated. PATIENTS AND DESIGN: Concentrations of PAI-1 antigen (Ag), adhesion molecules sE-selectin, sP-selectin, and intercellular adhesion molecule-1 (sICAM-1), FBG and levels of APR orosomucoid (ORM), and 'negative APR' transferrin (TRF) were established in 11 panhypopituitary (PHP) patients (eight men and three women, age median 39.0 years, body mass index (BMI) 27. 49 +/- 3.89 kg/m2) before and after 12-month replacement with rhGH. Control values were obtained by examination of 33 healthy age and sex matched subjects (24 men and nine women with BMI 24.16 +/- 1.99 kg/m2). RESULTS: PHP patients had higher concentrations of ORM (0.80 +/- 0.25, vs. 0.61 +/- 0.20 g/l; P = 0.05), FBG (3.22 +/- 0.48, vs. 2.57 +/- 0.47 g/l; P = 0.001), PAI-1 Ag (97.12 +/- 33.23, vs. 44.11 +/- 21.40 microgram/l; P = 0.001), sE-selectin (72.42 +/- 28.35, vs. 42. 80 +/- 12.60 microgram/l; P = 0.004), sP-selectin (221.26 +/- 75.12, vs. 104.79 +/- 26.01 microgram/l; P = 0.001) sICAM-1 (409.75 +/- 137.78, vs. 228.10 +/- 37.54 microgram/l; P = 0.001), and lower levels of TRF (2.14 +/- 0.40, vs. 2.76 +/- 0.39 g/l; P = 0.001) than controls. After 12-month rhGH replacement the patients showed an increase of TRF (2.64 +/- 0.84 g/l, P = 0.037) and decrease of soluble adhesion molecules (sE-selectin 57.98 +/- 27.04 microgram/l, P = 0.01, sP-selectin 121.74 +/- 50.42 microgram/l, P = 0.007; and sICAM-1 279.95 +/- 88.32 microgram/l, P = 0.005), which then, similarly to the ORM (0. 67 +/- 0.12 g/l) and FBG level (2.82 +/- 0.51 g/l), did not statistically differ from the values in the control group. CONCLUSION: rhGH replacement led to modulation of the 'inflammatory response' in panhypopituitary patients. This modulation occurred locally at vascular endothelium level where after rhGH replacement, sE-selectin, sP-selectin and sICAM-1 concentrations decreased, a similar effect as in the systemic inflammatory response, as was also apparent from the changes in acute phase response protein levels.

Adult↗

PubMed2000

[Analysis of the time course in electroretinography potentials].

1. For isolating of electroretinographic oscillatory potentials (Ops) a method of algebraic polynomial approximation of the low-frequency course of the electroretinogram is described. 2. Using the described method of approximation in 16 subjects, the isolated Ops displayed peak-latencies by 1-2 ms shorter than using the Fast Fourier Transform and a time window. Moreover, the amplitudes of OP1 were by 20% and of OP2 by 6% higher.

Electroretinography↗

PubMed2000

[Use of 5-fluorouracil in trabeculectomy].

The cytostatic 5-fluorouracil (5-FU) is used at present in the postoperative treatment of glaucoma. In 1993-6 we administered by the subconjunctival route at the Ophthalmological Clinic in Hradec Králové 5-FU to a group of 158 eyes after trabeculectomy (TE). The basic indication was ingrowth of the filtration vesicle or a rise of intraocular tension to 20 torr and more in 148 eyes. Preventively 5-FU was administered during operation during revisions of TE in 10 eyes. In the mentioned group with an unfavourable course of postoperative scar formation in the wound we achieved during the investigation period of two years after surgery normalization of the intraocular pressure to less than 16 torr without further treatment (we consider the value and condition without treatment as the optimal condition) in 37% of cases and in 81% less than 20 torr with treatment. Side-effects of administration of 5-FU (most frequently erosion of the corneal epithelium were transient. For the mentioned indications 5-FU appears, being a cytostatic where the dosage can be exact, sufficiently safe for administration and it exerts an optimal effect.

Adult↗

PubMed1999

Insulin action and fibrinolysis influenced by vitamin E in obese Type 2 diabetes mellitus.

Increased oxidative stress, hypofibrinolysis and insulin resistance are present in obese Type 2 diabetic patients. It is supposed that treatment with antioxidant alpha-tocopherol (vitamin E) could not only decrease free radical production, but also ameliorate insulin action. We evaluated the effect of 3 months administration of vitamin E (600 mg daily) on insulin action examined by hyperinsulinemic clamp in 11 obese Type 2 diabetic patients. Oxidative stress and fibrinolysis were also determined. The administration of vitamin E caused a decrease of glucose disposal rate (26.6 +/- 9.5 vs 21.3 +/- 7.5 micromol/kg/min, P < 0.02) and of metabolic clearance rate of glucose (3.7 +/- 1.6 vs 2.9 +/- 0.8 ml/kg/min. P < 0.02). A decrease of insulin receptor number was observed on erythrocytes after vitamin E (284 +/- 84 vs 171 +/- 59 pmol/l, P < 0.01). Significantly higher plasma malondialdehyde (MDA) concentration documented an increased oxidative stress in diabetic patients as compared with healthy persons (3.13 +/- 0.68 vs 1.89 +/- 0.18 micromol/l, P<0.001). An inverse relationship was found between MDA concentration and insulin sensitivity expressed by glucose disposal rate (r = -0.73). Vitamin E further worsened the hypofibrinolysis documented by a decrease of tissue plasminogen activator (P < 0.01) without changes in its inhibitor PAI-1. In conclusion. our results demonstrate that higher doses of vitamin E may further deteriorate insulin action and fibrinolysis in obese Type 2 diabetic patients.

Adult↗

PubMed1999

[Splenectomy].

The authors ANALYZE the problem of splenectomy from the historical point of view and also the problem of splenectomy indication. Two different periods separated by a short time interval are compared. Recently the indications for splenectomy have changed because of introduction of new drugs in hematologic treatment. The number of "traumatological" splenectomy remains constant. (Tab. 2, Ref. 18.)

Czech Republic↗

PubMed1999

[Hemostasis and levels of cytoadhesion molecules in gestational diabetes].

OBJECTIVE OF STUDY: Assess interrelations between parameters of haemostasis, fibrinolysis, acute stage proteins and cytoadhesive molecules in gestational diabetes (GDM), which in susceptible women is actively induced by insulin resistance. METHODS: In 33 pregnant women where based on the glucose tolerance test (75 g glucose) GDM was revealed, repeatedly fibrinogen values were assessed (FBG 4.38 +/- 0.98 g/l), the antithrombin III activity (ATIII% 103.83 +/- 14.9), t-PA Ag(4.82 +/- 3.35 ng/ml), PAI-1 Ag (158.04 +/- 57.7 ng/ml), D-dimer (234.99 +/- 455.36 ng/ml), plasma proteins-orosomucoid (ORM 0.506 +/- 0.14 g/l), C reactive protein (1.34 +/- 0.96 g/l), transferrin (3.77 +/- 0.79 g/l), prealbumin (1.86 +/- 0.83 g/l) and alpha-2-macroglobulin (A2M 2.01 +/- 0.62 g/l) and cytadhesive molecules sICAM-1 (230.8 +/- 57.76 ng/ml) and sE-selectin (35.50 +/- 16.55 ng/ml). These findings were compared with parameters of the glucose and lipid metabolism and some anthropometric data (BMI, weight increments during pregnancy and birth weight of the infant). RESULTS: After statistical evaluation in GDM positive correlations of FBG and BMI were found (r = 0.871, p = 0.007) and also with the weight increment during pregnancy (r = 0.934, p = 0.0007). Hyperfibrinogenaemia is however probably compensated in stabilized cases of GDM by a higher production of t-PA (FBG:t-PA Ag, r = 0.782, p = 0.003). In GDM a marginal positive correlation between the value of the "atheroindex" and the infant's length was found r = 0.744 p = 0.0547). sE-selectin levels in GDM correlated inversely with ATIII activity (r = -0.905, p = 0.0028). CONCLUSION: The higher body weight of pregnant women with GDM is probably associated with a higher risk of thrombophilia (elevated fibrinogen). If in pregnant women infection develops with release of inflammatory cytokines, inducing on the endothelium expression of E-selectin, deterioration of thrombophilia (due to a decline of ATIII) activity must be foreseen.

Acute-Phase Proteins↗

PubMed1999

Changes of signal-averaged ECG in normal subjects after one year.

Repeated signal-averaged electrocardiograms (SA ECG) were recorded twice with a mean interval of 13 months in 11 healthy volunteers in order to acquire basic information on long-term changes of SA ECG. After one year the duration of filtered QRS remains the most stable parameter of SA ECG on the contrary to parameters describing end of fQRS--i.e. both HFLA and RMS. Moreover fQRS seems to have better specificity in comparison to HFLA and RMS. An estimation of significant long-term changes in individual parameters of SA ECG was obtained. According to our results, only changes in QRS +/- 13 ms, fQRS +/- 8 ms, HFLA +/- 22 ms and RMS +/- 17 microV should be considered significant when found in a long-term follow-up of patients with a heart disease.

Adult↗

PubMed1999

[Anemia and its treatment with peroral anti-anemia agents in women during the postpartum period].

The prevalence of anaemia during pregnancy and post partum is according to the literature and many years clinical experience high. In the submitted work we investigated the incidence of sideropenic anaemia in women during the first three months after a spontaneous delivery, changes of clinical and laboratory indicators of anaemia during this period and the possible effect exerted by administration of iron and iron plus folic acid resp. Ninety pregnant women in the 35th to 39th week of pregnancy were at random divided into three equally sized groups and the following were assessed: haemogram, indicators of iron reserves, serum concentrations of folic acid, vitamin B12, erythropoetin and soluble transferrin receptor, liver tests, total protein + electrophoresis, acute stage proteins. In the first group (T) the women were given, starting on the 4th day after delivery 1 tablet of Tardyferon per day for two months. To the second group (F) for an equal period 1 tablet of Tardyferon Fol per day was administered. Women in the control group (K) had no medication. In the investigation women with medium and severe pregnancy anaemia were not included nor women taking during pregnancy or previously iron preparations or those treated in the past by blood transfusion. After spontaneous delivery (women who had Caesarean section or forceps delivery were eliminated from the study) the women were subjected to the same examinations as before delivery. These examinations were made on the fourth day after delivery and then after monthly intervals for a period of three months. At the same time the subjective condition of the mothers was evaluated after delivery, focused on the development of symptoms typical for anaemia and the possible effect of administered treatment. The investigation was completed by 60 women. During treatment no allergic or other serious side-reactions to the administered drugs calling for discontinuation of treatment were recorded. The results of the investigation proved that laboratory and clinical indicators of post-partum anaemia reached more quickly normal values in women treated with iron preparations. The authors did not detect a single and supreme marker of sideropenic anaemia in the early post-partum period. This is one of the reasons why the authors recommend iron administration to all women after spontaneous delivery. In the authors' opinion examination of the blood count on the fourth day and assessment of the serum ferritin concentration one month after a spontaneous delivery in selected mothers (e.g. after an above average peripartal blood loss) is desirable. Addition of folic acid to iron is of no special value during the post-partum period. Iron substitution in women after spontaneous delivery should be, with regard to the long persisting sideropenia, administered at least for three months. The dose of 80 mg elemental iron per day is sufficient for mild or medium post-partum anaemia. Addition of mucoprotease and ascorbic acid to iron preparations is useful because it increases the compliance of the patients and thus also its effectiveness. The preparation Tardyferon meets the above criteria and is therefore a good choice for the treatment of post-partum anaemia.

Administration, Oral↗

PubMed1999

The brain lesion influences the numbers of peripheral blood leukocytes in the rat.

The mutual relationship between the central nervous and immune system are intensively studied. The lesion of distinct structures of the rat brain such as septum influence the model immune response such as lymphocyte proliferation and delayed skin hypersensitivity. Employing the model of the damage of septum in the rat brain by electrolesion we demonstrated the decrease of the number of peripheral blood leukocytes, mainly cells exhibiting CD25 and CD45RA antigens in the rat. The striatum destruction has much lower influence on the studied parameters, which suggests a specific effect of the septum on these hematological parameters.

Animals↗

PubMed1999

[Antibiotic prophylaxis in hip joint surgery].

Nosocomial deep wound infections are serious complications after hip joint surgery. Our aim was to determine whether there is a difference in rates of nosocomial infections between group of patients after elective surgery of hip replacement and group of patients with hip replacement after trauma. Both groups of patients had perioperative prophylaxis with amoxycillin. We found that the overall trauma patients infection rate was 0.9 per cent compared with 1.5 per cent for elective surgery infections. In both groups of patients a postsurgery stress was documented according to increase of acute phase proteins (C-reactive protein, orosomucoid and fibrinogen) in plasma for a minimum 10 days after surgery. We conclude, that both groups of patients had benefit from amoxycillin prophylaxis therapy.

Acute-Phase Proteins↗

PubMed1999

[Evaluation of the effect of plastic casts from the aspect of prevention of thromboembolic disease].

Immobilization after trauma escalates risk of thrombosis. Our objective was to determine whether there is a difference in rates of deep vein thrombosis (DVT) after immobilization with plastic casts or routinely plaster of Paris in trauma patients. Despite both groups of patients do not show difference in blood coagulation tests (APTT, TT, PT, levels of fibrinogen and of D-dimer in plasma) during time of immobilization the evidence of DVT according to scintigraphy was lower in group of patients with plastic casts (3 per cent to 10 per cent).

Adolescent↗

PubMed1999

[Changes in late potentials in the time period after myocardial infarct].

Late potentials are thought to be a non-invasive marker of discrete morphologic and electrophysiologic changes of the ventricular myocardium caused by fibrosis due to myocardial infarction. To find out whether there are significant changes in the signal-averaged ECG (SA ECG) over one year we examined 30 patients following myocardial infarction. When compared to the initial findings, significantly decreased incidence of late potentials was found after one year. Most of the changes in the filtered QRS were located in the terminal portion of the fQRS--in the area of low amplitude signals. Significant differences were noted in the changes found in patients with anterior myocardial infarction (MI) compared with the changes found in patients with posterior MI.

Electrocardiography↗

PubMed1998

[Can normalization of vascular cytoadhesive activity be explained by the anti-atherosclerosis effect of growth hormone?].

BACKGROUND: The increased mortality caused by premature atherosclerosis has been shown among patients with hypopituitarism receiving conventional hormone treatment but with unsubstituted growth hormone deficiency. This experience belongs among the most important arguments in favour of replacement with growth hormone. The mechanisms of the antiatherogenic effect of growth hormone are poorly understood. The protective effect of growth hormone on the vascular endothel and its intervention in the clotting process, which have not been yet elucidated, may be the causative factors. METHODS AND RESULTS: The endothelial damage as given by measuring of circulating soluble cytoadhesive molecules sE-selectin, sP-selectin and intercellular adhesive molecule 1 (ICAM 1) was measured in 15 adult panhypopituitaric patients before and after 1 year treatment with recombinant human growth hormone. The blood levels of all of these cytoadhesive molecules decreased significantly (p < 0.01) during the treatment. None of the concomitantly followed coagulation tests (prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin III, von Willebrand's factor and D-dimer) was significantly changed during the treatment. The tendency to decrease (p = 0.054) was observed with antithrombin III. CONCLUSIONS: The decrease of circulating cytoadhesive molecules in blood during the treatment of growth hormone gives evidence for its protective effect, either direct or mediated, on the vascular endothel. These findings could bring an explantation for the premature atherosclerotic changes in hypopituitarism and antiatherogenic effect of growth hormone.

Adult↗