Background: We tested whether the level of endothelial dysfunction assessed by digital tonometry, and expressed as reactive hyperemia index (RHI), is related to occurrences of a discrepancy between fractional flow reserve (FFR) and the instantaneous wave free ratio (iFR) (ClinicalTrials.gov identifier: NCT03033810).Methods: We examined patients with coronary stenosis in the range of 40-70%, assessed by both FFR and iFR (system Philips-Volcano) for stable angina. We included consecutive patients with FFR and iFR in one native coronary artery, and who had had no previous intervention.Results: We included 138 patients. Out of those, 24 patients (17.4%) had a negative FFR (with an FFR value >0.8) and positive iFR (with a iFR value ≤0.89) - designated the FFRn/iFRp discrepancy group, and 22 patients (15.9%) had a positive FFR (≤0.8) and negative iFR (>0.89) - designated the FFRp/iFRn discrepancy. RHI was higher in the discrepancy groups compared the group without discrepancy (1.73 ± 0.79 vs. 1.48 ± 0.50, p = 0.025). However, this finding was not confirmed in multivariant logistic regression analyses. Patients with any type of discrepancy differed from the agreement group by having a higher occurrence of diabetes mellitus [9 patients (21.4%) vs. 36 patients (39.6%), p = 0.029], active smoking (23 patients or 54.8% vs. 26 patients or 28.6%, p = 0.003) and lower use of calcium channel blockers (9 patients, 21.4%, vs. 43 patients, 46.7%, p = 0.004).Conclusion: The presence of endothelial dysfunction can be associated with a discrepancy in FFR/iFR. However, RHI correlated with risk factors of atherosclerosis, not with FFR or iFR.

• Klíčová slova
• Coronary disease, endothelial cells, fractional flow reserve,
• MeSH
• cévní endotel patofyziologie   MeSH
• cévní rezistence MeSH
• frakční průtoková rezerva myokardu * MeSH
• koronární stenóza * diagnóza   patofyziologie   MeSH
• laser doppler flowmetrie * přístrojové vybavení   metody   MeSH
• lidé MeSH
• manometrie přístrojové vybavení   metody   MeSH
• mikrocirkulace fyziologie   MeSH
• navrhování softwaru * MeSH
• počítačové zpracování obrazu MeSH
• senioři MeSH
• software MeSH
• zobrazování myokardiální perfuze metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

We experimentally characterized a birefringent side-hole microstructured fiber in the visible wavelength region. The spectral dependence of the group and phase modal birefringence was measured using the methods of spectral interferometry. The phase modal birefringence of the investigated fiber increases with wavelength, but its positive sign is opposite to the sign of the group modal birefringence. We also measured the sensing characteristics of the fiber using a method of tandem spectral interferometry. Spectral interferograms corresponding to different values of a physical parameter were processed to retrieve the spectral phase functions and to determine the spectral dependence of polarimetric sensitivity to strain, temperature and hydrostatic pressure. A negative sign of the polarimetric sensitivity was deduced from the simulation results utilizing the known modal birefringence dispersion of the fiber. Our experimental results show that the investigated fiber has a very high polarimetric sensitivity to hydrostatic pressure, reaching -200 rad x MPa(-1) x m(-1) at 750 nm.

• MeSH
• analýza selhání vybavení MeSH
• design vybavení MeSH
• dvojitý lom MeSH
• manometrie přístrojové vybavení   metody   MeSH
• měniče * MeSH
• poréznost MeSH
• refraktometrie přístrojové vybavení   metody   MeSH
• technologie optických vláken přístrojové vybavení   MeSH
• testování materiálů MeSH
• tlak MeSH
• vyrobené materiály analýza   MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) is a safe and effective bariatric operation for the treatment of morbid obesity. Optimized long-term weight loss and reduced complications may be facilitated by development of a standardized, accurate, band-fill measurement methodology for use in postoperative LAGB adjustments. METHODS: A summary of the primary in vitro, theoretical, and in vivo studies of pressure-volume theory relative to gastric banding was undertaken. RESULTS: LAGBs range in mechanisms of action from low-pressure/high-volume to high-pressure/low-volume. Use of both basic and dynamic pressure data obtained experimentally and clinically with a low-pressure/high-volume (LP/HV) band as a research tool revealed that intra-band pressures remained very low even when the band balloon was filled to its maximum fill volume; in contrast, when a high-pressure/low-volume (HP/LV) band was filled, it exhibited a pressure curve markedly steeper and of greater amplitude than that of the LP/HV band. Theoretical calculations of the differences between the bands in terms of the pressures they exerted on a bolus of food passing through a stoma found that the pressure created by the HP/LV band against the gastric wall was >100% higher than that applied by the LP/HV band; these mathematical results were verified by using invasive manometry in 35 patients undergoing band adjustment. In clinical testing, basic band pressure, band volume, and dynamic pressure data (that demonstrated esophageal motility patterns at the stoma during bolus passage) were gathered and correlated. As identified by intra-band pressure readings, a zone of disruptive peristaltic activity that obstructed bolus passage through the stoma was observed; slightly beneath this zone, it was hypothesized that successful patient adjustments might be carried out. The manometrically delineated measure of mean band pressure sufficient to exert a significant yet not disruptive restriction (i.e., 20 mm Hg; mean volume of 5.4 mL) was tested in 25 patients in follow-up. No patient required readjustment due to obstruction. Intra-band pressure, as opposed to band-fill-volume measurement, per se, was shown to produce a more accurate measurement of actual band (stoma) restriction in individual patients, and to identify a pressure "green zone" for effective restriction at adjustments. DISCUSSION: Ongoing scientific studies are needed to refine pressure-volume theory by using laboratory, theoretical, and clinical manometry to establish a reliable pressure-based algorithm for gastric band adjustment. Such an algorithm may lead to more consistent weight loss, fewer complications, and more compliant patients.

• MeSH
• algoritmy MeSH
• gastroplastika škodlivé účinky   metody   trendy   MeSH
• hmotnostní úbytek MeSH
• laparoskopie metody   MeSH
• lidé MeSH
• manometrie přístrojové vybavení   MeSH
• morbidní obezita chirurgie   MeSH
• tlak MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Peripheral wave reflection augments central blood pressure and contributes to cardiac load. This pressure augmentation is not quantifiable from brachial cuff pressure but can be determined from carotid pulsations using the augmentation index (AI). However, carotid tonometry is technically challenging and difficult to standardize in practice. We tested whether automated radial pressure analysis provides a viable alternative. METHODS AND RESULTS: Carotid and radial AI (cAI, rAI) were measured in 46 volunteers with a broad range of arterial properties. Data were assessed at rest, during a cold-pressor test, and following 0.4 mg of sublingual nitroglycerin. cAI correlated with rAI independent of age, mean blood pressure (BP), gender or body mass (cAI = 0.79 x rAI - 0.467, r = 0.81, P < 0.00001), with zero mean bias. There was individual variability in the prediction (difference of -4 +/- 23%), though 65% of the estimates fell within 15% of each other. Change in rAI and cAI with provocative maneuvers also correlated (r = 0.77, P < 0.001). Both cAI and rAI were nonlinearly related to late-systolic pressure-time integral (PTI), an index of cardiac load. At cAI < 0.1 or rAI < 0.69, PTI was unaltered, while greater values correlated with increased PTI. rAI accurately predicted this cut-off in 88% of cases, with a 5.5% false negative rate. CONCLUSIONS: Automated rAI analysis is an easily applied method to assess basal and dynamic central pressure augmentation. While individual predictive accuracy of cAI was variable, overall population results were consistent, supporting use of rAI in clinical trials. Its prediction of when AI is associated with greater LV loading (i.e. cardiac risk) is good and may help stratify individual risk along with brachial cuff pressure.

• MeSH
• arteria radialis fyziologie   MeSH
• arteriae carotides fyziologie   MeSH
• dospělí MeSH
• hypertenze diagnóza   patofyziologie   MeSH
• kontrakce myokardu fyziologie   MeSH
• krevní tlak fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• manometrie přístrojové vybavení   metody   MeSH
• měření krevního tlaku přístrojové vybavení   metody   MeSH
• mladiství MeSH
• pružnost MeSH
• pulzatilní průtok fyziologie   MeSH
• rychlost toku krve fyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

OBJECTIVE: Manometric findings in achalasia are pathognomic already in early clinical stages of the disease. The authors evaluate the importance of manometry in the diagnosis and therapy, in particular in early stages of the disease. METHOD: During manometry we obtain data on the function of the lower oesophageal sphincter and the body of the oesophagus. Impaired relaxation of the sphincter is evaluated, as well as increased tonus of the sphincter and tertiary contraction of the body of the oesophagus. In patients with achalasia we implement laparoscopically extramucous myotomy. RESULTS: In 1997 we started a prospective manometric study of dysphagic complaints. We examined 304 patients on account of different diseases of the oesophagus incl. 16(5.2%) where we proved or confirmed achalasia in stage I, II or III according to the radiological classification. These patients were indicated for laparoscopic myotomy. In one instance we had to convert the operation to an open one. In two instances we added partial fundoplasty according to Thal on account of perforation of the oesophageal mucosa. Four patients were subjected after a 5-12-month interval to remyotomy. Twice because of the development of a fibrous stricture at the site of myotomy and twice for an obviously inadequate original myotomy. The history of dysphagia in patients with primary operations was on average 37.3 months. CONCLUSIONS: Manometric examination of patients with functional dysphagia makes it possible to detect achalasia in early stages and to indicate in time surgical treatment. In case of a relapse or persistence of complaints manometry makes it possible to express objectively the cause which is most frequently an atonic oesophagus with inadequate evacuating capacity, stricture at the site of myotomy or inadequate myotomy.

• MeSH
• achalázie jícnu diagnóza   chirurgie   MeSH
• dospělí MeSH
• ezofágus patofyziologie   MeSH
• gastroezofageální junkce patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• manometrie přístrojové vybavení   metody   MeSH
• prospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• práce podpořená grantem MeSH

The authors present their initial experience with anal manometry using a PC Polygraph of Synectics Medical Co. They discuss the manometric examination of 14 patients with ulcerative colitis, incl. 12 who were operated. In all 12 patients an ilea-pouch-anal anastomosis was made. By manometry a postoperative drop of pressures at rest was found and partly also of pressures during muscular contraction as well as shortening of the zone of high anal pressure. The resulting values, however, did not influence continence, except for temporary soiling, the frequency of bowel movements being 2-8. Anal manometry is an important objective examination of the sphincter function as it makes it possible to compare values before and after therapy. It must be however combined with other anorectal physiological tests such as endosonography, EMG, defaecography etc.

• MeSH
• anální kanál patofyziologie   chirurgie   MeSH
• dospělí MeSH
• fekální inkontinence patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• manometrie přístrojové vybavení   MeSH
• mladiství MeSH
• rektum patofyziologie   chirurgie   MeSH
• ulcerózní kolitida patofyziologie   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• anální kanál patofyziologie   MeSH
• chronická nemoc MeSH
• dítě MeSH
• lidé MeSH
• manometrie přístrojové vybavení   metody   MeSH
• mladiství MeSH
• předškolní dítě MeSH
• rektum patofyziologie   MeSH
• zácpa patofyziologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• manometrie přístrojové vybavení   metody   MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• intrakraniální tlak * MeSH
• kuřecí embryo fyziologie   MeSH
• manometrie přístrojové vybavení   metody   MeSH
• zvířata MeSH
• Check Tag
• kuřecí embryo fyziologie   MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• laryngostenóza diagnóza   MeSH
• lidé MeSH
• manometrie přístrojové vybavení   MeSH
• metody MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH