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J Veselka

Publications and source records attributed to J Veselka.

36 records · Page 2Linked to original sources
PubMed1999

[Ultrasonography study of the mammary-coronary bypass].

The authors present the case of a 49-year-old female patient who was admitted with the diagnosis of ischaemic heart disease and the syndrome of angina pectoris grade IV for selective coronarography. For assessment of the affection of one artery, significant stenosis of the insertion of the ramus interventricularis anterior the authors indicated a bypass of the left mammary artery to the ramus interventricularis anterior. During the postoperative course the patient did not have any anginous symptoms or any other clinical signs suggesting ischaemia or necrosis of the heart muscle. During the ultrasonographic check-up examination of the mammarocoronary bypass the suspicion of occlusion of the graft was expressed and this was confirmed on angiography. An angiographically successful percutaneous transluminal angioplasty of occlusion of the bypass was made. During the subsequent ultrasonographic examination the authors suspected again graft occlusion and angiography confirmed a 90% stenosis. Therefore the patient was re-operated. It appears that ultrasonographic examination of the mammacoronary bypass may prove useful in the diagnosis of occlusion or critical stenosis of a graft.

Coronary Disease↗
PubMed1999

["Ambulatory" approach to selective coronary angiography: our results and experience].

The authors present a group of their first 110 patients subjected to selective coronarography during an average 7-hours hospitalization period. In selection of patients they respect the criteria ruling out the following approach: age above 70 years, distance of the patients domicile above 80 km or inaccessibility of catheterization laboratory within 45 minutes, serious aortic valve disease, unstable coronary syndromes, insulin treated diabetes mellitus, renal insufficiency, cardiac insufficiency, grade III or IV, severe left ventricular dysfunction, history of malignant arrhythmia, acute myocardial infarction or cerebrovascular attack during month preceding examination, coronary finding calling for urgent revascularization, complicated course of examination and mental inability of patient. All coronarographies were performed by a 4F catheterization instrument, no complications were recorded and readmission to hospital was not called for. An early check-up by telephone was accepted by half the patients. When all the above criteria are respected the authors recommend this procedure as a standard one without the need of hospital admission.

Ambulatory Care↗
PubMed1998

Esophageal achalasia compressing the heart diagnosed by echocardiography.

We present a patient with severe decompensated esophageal achalasia in whom transthoracic echocardiography revealed compression of the left heart chambers caused by the dilated esophagus representing a posterior mediastinal mass. This case also illustrates the ability of echocardiography to monitor success of treatment of decompensated achalasia. An important role of echocardiography in the diagnosis of mediastinal masses is emphasized.

Adult↗
PubMed1998

[Reversible dysfunction of myocardial contraction].

It has been known for more than 20 years that in some patients after revascularization partial or complete improvement of previous left ventricular dysfunction occurs. The condition for this improvement is viable myocardium, i.e. contractile reserve. Chronic reversible contractile dysfunction, also called hibernating myocardium heart muscle is along with the presence of acute reversible dysfunction--a stunned myocardium the prerequisite for this improvement. In the submitted review the authors try to present at least some contemporary views on the pathophysiological mechanism of the development of a hibernated myocardium. The normal blood flow through the heart muscle at rest in the majority of reversibly dysfunctional segments is a change as compared with the formerly accepted definition. The authors mention histological changes of the hibernating myocardium, in particular so-called dedifferentiation. Attention is paid to a review and comparison of methods used at present to detect a viable myocardium. From the aspect of clinical practice it appears that unless revascularization occurs, the presence of a viable heart muscle is a factor which causes a poorer prognosis of the patients.

Humans↗
PubMed1998

[Treatment of significant coronary stenoses using stents without preliminary balloon angioplasty: present status, results, perspectives].

The authors present an account on a group of 57 patients where they tried to treat 58 significant coronary stenoses by means of direct stenting without predilatation. In two patients they were able to implant the stent only after previous dilatation, in one instance postdilatation was necessary because of a residual stenosis of more than 20% and in one instance it was necessary to implant another stent on account of distal dissection. Direct stenting was successful in 93%. At the significance level of p < 0.05 significantly shorter fluoroscopic and total intervention times were achieved as compared with the control group where the standard procedures of stenting after previous balloon angioplasty was used. The authors conclude that direct stenting without previous dilatation is a safe method which can be used with the contemporary instrumental equipment in approximately 20% of carefully selected lesions.

Angioplasty, Balloon, Coronary↗
PubMed1998

[Catheterization therapy of the left main coronary artery in chronic stenosis of the right coronary artery. What are the limits of interventional cardiology?].

The authors give an account of a 59-year-old patient with a significant stenosis of the left main coronary artery and occlusion of the right coronary artery, occlusion of the ramus interventricularis anterior after failure of surgical revascularization and with a left ventricular ejection fraction of 20%. The authors performed a successful percutaneous coronary angioplasty of the left main coronary artery with an implantation of a stent. They discuss contemporary possibilities and limitations of catheterization treatment of stenosis of the left main coronary artery.

Angioplasty, Balloon, Coronary↗
PubMed1997

[Estimation of the mean right atrial pressure using echocardiography].

The authors measured in a group of 30 patients invasively the pressure in the right atrium and at the same time or within 60 minutes the diameter of the interior vena cava and its changes in conjunction with respiration. They revealed a statistically significant relationship between all parameters of the diameter of the interior vena cava assessed by echocardiography and the mean right atrial pressure. The closest correlation was found in the index of the inspiration diameter of the inferior vena cava (p = 0.01; r = 0.824). A critical value of the index of the inspiration diameter of the inferior vena cava greater than or equal to 10 mm revealed patients with a pathologically elevated pressure in the right atrium with a 100% sensitivity and 88.9% specificity. Measurement of the diameter of the inferior vena cava and its respiratory variations is a suitable method for estimation of the mean right atrial pressure.

Adult↗
PubMed1997

[Effect of a revascularization procedure on functioning of the hibernating myocardium].

Persistent abnormalities of left ventricular wall motion in patients with chronic coronary artery disease can be reversed by successful coronary artery bypass surgery or coronary angioplasty. The identification of hibernating myocardium has therefore important therapeutic and prognostic implications. Echocardiography with low dose dobutamine infusion can detect viable myocardium in patients with chronic left ventricular dysfunction. We have studied 32 patients with angiographically confirmed coronary artery disease and left ventricular dysfunction. The effect of dobutamine infusion (5 micrograms/kg/min. followed by 10 micrograms/kg/min) on left ventricular function was evaluated before coronary revascularization (PTCA, n = 20); CABGm b = 12) and compared with early period after revascularization (1-7 days) and 6-7 months later. Before revascularization 226 segments were hypokinetic, akinetic or dyskinetic, improvement was observed in 122 segments during dobutamine echocardiography. Mean (+/- SD) segment score indexes were 2.50 +/- 0.17 at baseline, 2.04 +/- 0.19 (p < 0.001) after dobutamine infusion, 2.24 +/- 0.25 (p < 0.001) early after and 1.87 +/- 0.25 (p < 0.001) late after revascularization. Sensitivity of dobutamine infusion to predict improvement early and late after revascularization was 84% and 85% respectively, specificity was 85% and 90% respectively. Echocardiography during low dose dobutamine infusion is save and accurate method for identifying of hibernating myocardium and predicts early and late reversibility of wall motion in selected patients with coronary artery disease and chronic left ventricular dysfunction.

Cardiotonic Agents↗
PubMed1996

Anomalous origin of the right coronary artery from the pulmonary trunk: is surgical reimplantation into the aorta a method of choice?

The origin of the right coronary artery (RCA) from the pulmonary trunk (PT) is a rare congenital anomaly. Although most of the patients remain asymptomatic, prophylactic reimplantation of the RCA into the aorta has been recommended to prevent an adverse outcome. The report describes postoperative results in two patients following uneventful RCA reimplantation. A 47-year-old man, with coexisting diffuse atherosclerotic involvement of the left coronary artery, remained symptomatic despite the establishment of a two-coronary system. The second patient, a 36-year-old woman, with isolated anomalous origin of the RCA from the PT, continued to present with myocardial ischemia on exertion. The original observation of an angiographic "slow-flow" phenomenon in the reimplanted RCA in both patients implies the impairment of myocardial microvessels. These findings give rise to the question of whether the reimplantation of the anomalous artery is really superior to simple ligation of its origin in order to relieve the "coronary steal" effect.

Adult↗
PubMed1996

[Flow in pulmonary veins].

Pulmonary venous flow can be evaluated by means of pulsed Doppler echocardiography during a transthoracic or transesophageal echocardiography examination. In most cases a three-peak spectral curve with highest positive wave during ventricular systole, a lower positive wave during ventricular diastole and a small negative wave during the left atrial contraction are recorded. Multiple factors affect the systolic and diastolic components of pulmonary venous flow. Pulmonary venous flow measurement may prove to be an important tool in routine judgment of diastolic left ventricular and atrial function. With regard to clinical importance, the pulmonary venous flow is a useful parameter for left atrial pressure quantification and for differential diagnosis of restrictive cardiomyopathy and constrictive pericarditis.

Blood Flow Velocity↗
PubMed1996

[Prevention of thromboembolism in patients with atrial fibrillation].

Atrial fibrillation is a disorder of the cardiac rhythm associated with an increased risk of thromboembolism. Several studies in the past confirmed that anticoagulation or also antiaggregation therapy is associated in these patients with a reduced incidence of cerebrovascular attacks and peripheral embolism. For a more objective assessment of the risk of individual patients risk factors of thromboembolism in atrial fibrillation were defined. They include cardiac insufficiency, hypertension, a history of embolism, left atrial dilatation, systolic dysfunction of left ventricular hypertrophy and spontaneous echo contrast. This risk stratification of patients with atrial fibrillation is the basis for correct selection of subsequent treatment. In patients without risk factors treatment with acetylsalicylic acid can be recommended, if older than 60 years. In younger patients no treatment is necessary for prevention of thromboembolism in this group. In the presence of one or several risk factors permanent anticoagulation treatment with a target value of INR 2.5 is necessary. In patients with atrial fibrillation associated with a congenital or acquired heart disease warfarin is administered with a target value of INR 3-4. The same approach is used in patients with chronic and paroxysmal atrial fibrillation.

Atrial Fibrillation↗
PubMed1995

[Lyme carditis].

The authors present in the submitted paper the basic characteristics of Lyme carditis as one of the forms of Lyme borreliosis. They mention briefly the clinical symptoms, diagnostic possibilities and causal and symptomatic therapeutic procedures. In the second part they present conclusions which they obtained by comparison of data in the literature and their own experience with dispensary care of 50 patients during several years. In the conclusion they emphasize the great interindividual variability of the clinical picture not only in the acute stage of the disease but also for years after treatment.

Adolescent↗
PubMed1995

[The importance of measuring pulmonary venous flow using doppler echocardiography].

Pulmonary venous flow can be evaluated by means of pulsed Doppler echocardiography during transthoracic or even better during transoesophageal examination. In the majority a three-peak spectral curve is recorded with the highest positive wave during ventricular systole, a lower positive wave during ventricular diastole and a negative wave during contraction of the left atrium. The author discusses some factors which have an impact on the pulmonary venous flow and which must be taken into account for its correct evaluation. With regard to clinical importance the author emphasizes in particular the change of venous pulmonary flow when the pulmonary pressure in the left ventricle rises. The latter may be used for its estimation. The pulmonary venous flow is a useful parameter also for quantification of significant mitral regurgitation and the differential diagnosis of restrictive cardiomyopathy and constrictive pericarditis. With regard to the simple assessment, rapidity of assessment and its predictive value it is suited for routine use in the majority of echocardiographic laboratories.

Blood Flow Velocity↗
PubMed1995

Lyme carditis.

Explore the source record for details and available documents.

Adolescent↗
PubMed1990

[Testing student knowledge of emergency care at the Charles University School of General Medicine and the processing of certain conditions in primary emergency care into computerized educational training models].

The objective expression of the state of knowledge of 6th year students of the Faculty of General Medicine in the field of emergency care is an important factor in the evaluation of their preparation for the medical profession, regardless of the specialty they choose. Knowledge of these data is essential for improvement of undergraduate teaching of emergency care. Suitable application of computer technique can supplement the possibilities how to achieve this. The application of so-called model situations on personal computers makes it possible to extend training of decision taking to all spheres of medical training.

Computer Simulation↗
PubMed1989

[Scintigraphic diagnosis of abscesses and other inflammatory processes using indium 111In labeled leukocytes].

Autologous polymorphonuclear leucocytes are injected after separation and labelling with 111In oxine to the patient with a suspect inflammatory process and after 24 hours their localization is assessed by standard scintigraphic examination by a scintillation camera. The authors examined in a prospective investigation 33 patients--the sensitivity of the method was in that group 80%, the specificity 100%, the diagnostic accuracy 94%. The authors discuss the possibilities of application of the method in intraperitoneal abscesses and in some inflammations with another localization. They evaluate the contribution of the method in the diagnosis of inflammatory processes, as compared with the possibilities offered by computed tomography and ultrasound.

Abscess↗
PubMedDate not supplied

Determination of the photon spectrum of a clinical accelerator.

An experiment to determine the peak of the energy spectrum of the photon beam from a Toshiba LMR-15 medical linear accelerator is described. It is found that the flattening filters removed much of the bremsstrahlung spectrum below approximately 1 MeV, resulting in a photon spectrum which peaks around 1.2 MeV.

Particle Accelerators↗