[Own modification of the method of introduction of endocavitary electrode by way of puncture of the subclavian vein].
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Biomedical subjects
Publications and source records attributed to R Trojnar.
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Sixty-five patients with myocardial infarction were observed for comparison of the values of nalorphine and Micoren in prevention of respiratory depression caused by fentanyl. The patients were divided into 4 groups receiving NLA II with or without nalorphine, morphine or Micoren. In all cases paO2, paCO2 and acid-base equilibrium were determined before and after administration of drugs. In the group receiving only NLA II paO2 fell in 50% of cases, in other groups receiving nalorphine or Micoren it increased in most cases. The paCO2 increased in most cases in groups receiving only NLA II or NLA II with nalorphine with or without morphine and respiratory acidosis developed in 4 cases. In the group receiving NLA II with Micoren paCO2 fell. The results indicate the necessity of administration of respiratory stimulants with NLA II and Micoren appears to be preferable to nalorphine in this respect.
The systolic and diastolic left-ventricular myocardium function was assessed by Doppler echocardiography in patients with hypertension. The study was carried out on 40 patients (26 men and 14 women) aged 21-50 years (mean 45 years) with essential hypertension, stage II according to WHO classification. The control group comprised 20 healthy subjects aged 19-48 years (mean 43 years). In patients with hypertension, as compared to controls, the Doppler curve of aortic flow showed an increased maximal and mean velocity of flow, the ejection time was shortened, and the ejection time to acceleration time index was decreased. The Doppler curve of the mitral flow in the patients showed reduced maximal velocity of early diastolic flow, increased velocity of maximal end-diastolic flow, decreased fraction of rapid left-ventricular filling, and lower ration of maximal early diastolic to end-diastolic flow. Doppler echocardiography is a useful method for assessment of left-ventricular myocardium functions in hypertension.
The reported study was carried out in 30 men with myocardial infarction. In all cases after completion of rehabilitation treatment in hospital the exercise test was done on cycle ergometer and echocardiographic examination was performed (TM, 2D and Doppler). The patients were divided into two groups depending on the size of the necrotic zone (limited or extensive infarction in ECG) and physical fitness (low and high) determined by means of the PCW-170 test. In such formed groups certain left-ventricular contraction parameters (PEP, PEPI, LVET, LVETI, PEP/LVET, CO) were calculated by means of Doppler echocardiography. It was found that after hospital rehabilitation the patients with extensive myocardial infarction had significantly lower values of LVETI, SV, CO and higher PEP/LVET value in relation to patients with limited infraction zone, which suggested worse left-ventricular contraction. Moreover, patients with lower physical fitness had worse left ventricular contraction activity (significantly lower values of LVET, LVETI, SV, CO, and higher value of PEP/LVET) than patients with better fitness. Thus the indices describing the left-ventricular contraction activity calculated by means of Doppler echocardiography correlated well with fitness and infraction zone size. The method of Doppler echocardiography is useful for determination of left-ventricular contraction activity after myocardial infraction and for programming of exercises during rehabilitation treatment in hospital.
On the basis of echocardiographic investigations changes were analysed of certain haemodynamic parameters in 40 patients aged 21-50 years, mean 44 years, with primary arterial hypertension in stage II according to WHO classification. All patients were randomly chosen to receive for 6-9 weeks propranolol 120-480 mg daily, mean dose 280 mg, or pindolol 10-35 mg daily, mean dose 22 mg daily. The changes developing during the treatment with both drugs in relation to the initial values included the mean arterial blood pressure, the heart rate, the index of cardiac output and the systolic left-ventricular tension. In the studied patients treated with propranolol the heart rate and the ejection volume were decreased more than during pindolol treatment. Propranolol increased evidently the total peripheral vascular resistance and decreased the ejection fraction and the mean velocity of shortening of the circumferential fibres. Pindolol decreased slightly the peripheral vascular resistance and increased the ejection fraction and the mean velocity of shortening of the circumferential fibres. Pindolol, in relation to propranolol, had a more favourable effect on haemodynamics in patients with primary hypertension.
Auricular over-stimulation is used by some researchers to study patients under suspicion of coronary heart disease. In this paper we discuss the changes in telediastolic pressure of the left ventricle (PT-DVI), stimulating the right auricle with increasing frequencies sent through an external pacemaker. When the ventriculography and coronarography were over, the Sones catheter was left into the left ventricle. An electrode-catheter was introduced through vein in the right auricle, the distal end being very close to the sinusal node, where the electric catch as accomplished. Through this stimulator the cardiac frequency was increased in 20 heart beats more than the basal cardiac frequency and the PTDVI was simultaneously measured every 3 minutes. Through the coronarographic study, the patients were classified in: normal, bi-vascular and tri-vascular. The increase and decrease of PTDVI was calculated in relation to the results obtained during the last minutes of over-stimulation compared with the basal figures. Most of the patients showed a decrease in PTDVI no matter what the vascular engagement was. Our results show there is no difference between the response and the coronary obstruction degree so, this evidence is of no value to judge the functional situation of the left ventricle.
The investigations were carried out in 296 patients with myocardial infarction (238 men and 58 women) aged 24-91 years, admitted to an intensive care unit on the 1st or 2nd day of the disease. In all patients the catheter for determination of central venous pressure was introduced into the right atrium through the cephalic vein the the first 100 cases, and through the subclavian vein in 196 cases. The catheter was kept in the atrium for 3-4 days. Values of c.v.p. between 50 and 120 mm Hg were accepted as normal.