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Objectives: Arterial hypertension may lead to the development of organ changes. This study compares different personality traits in hypertensive patients with and without left ventricular hypertrophy and arterial stiffness., Methods: The study group consisted of 93 subjects (47 males and 46 females) with primary hypertension. Left ventricular mass index (LVMI) and pulse wave velocity (PWV) were evaluated and used as markers of cardiac and vascular damage. Personality traits of each patient were assessed using three psychometric tools: NEO-FFI, DS14 and EAS., Results: Patients with increased PWV scored significantly lower than individuals with normal PWVin the following scales: NEO-FFI Neuroticism (18 vs. 27.5; p = 0.018), DS14 Negative affectivity (11.5 vs. 17; p = 0.035) and EAS Fear (10 vs. 13; p = 0.004). Subjects with left ventricular hypertrophy (increased LVMI values) presented lower levels of openness to experience (measured by the NEO-FFI) than persons with normal LVMI values (23 vs. 26; p = 0.027)., Conclusions: These findings suggest that there are significant differences in personality traits between hypertensive patients with and without vascular and cardiac damage.

Objectives: The aim of the study was to evaluated the impact of metabolic control in pregnant women with PGDM on uteroplacental circulation parameters during pregnancy., Material and Methods: The study group included 141 pregnant women divided into 3 subgroups: PE + GH group (n = 16)--woman suffering from PGDM, with superimposed PE or GH, the PGDM group (n = 84)--women suffering from PGDM without hypertension, and the control group--41 healthy women in uncomplicated pregnancy. All participants were monitored for metabolic control and uteroplacental circulation parameters during pregnancy. The survey was completed after the data from the perinatal period were collected., Results: The differences between the uterine artery pulsatility index (Pi UtA) in the first trimester of pregnancy expressed as a multiple of the median (MoM), were not statistically significant between the groups (p ≥ 0.42). Also, no statistically significant differences were observed between the groups Pi UtA in the second (p ≥ 0.33) and third trimester of pregnancy (p = 1.0). The rate of fetal growth was comparable in all groups. Infant birth weight percentile in the study groups did not differ statistically (p ≥ 0.15)., Conclusions: Tight metabolic control during pregnancy in women suffering from PGDM allows to obtain blood flow in the uteroplacental circulation which is comparable to their healthy pregnant peers.

Objectives: Comparison of fetal umbilical and middle cerebral artery flow between early- and late-onset preeclampsia., Material and Methods: Our study was conducted among 50 patients with preeclampsia in the third trimester of pregnancy and included 30 women with early-onset and 20 with late-onset disease. Early-onset preeclampsia (EOP) and late-onset preeclampsia (LOP) were defined as onset of the disease before and after 34 weeks of gestation, respectively Doppler examinations of the fetal umbilical and middle cerebral artery were performed in all patients. Pulsatility Index (PI) and cerebral-umbilical ratio (CUR) were measured each time., Results: Mean value of the umbilical artery PI was significantly higher in fetuses of patients with EOP in comparison to LOF, whereas mean PI value in MCA was significantly lower in fetuses from the group with EOP than LOP The percentage of abnormal results of fetal Doppler examinations, both in the umbilical artery and middle cerebral artery was significantly higher in EOP than in LOP. The same tendency was observed for CUR., Conclusions: 1. Early-onset preeclampsia is characterized by significantly higher degree of placental insufficiency than late-onset disease. 2. The obtained results indicate a significant, pathological role of the placenta in early-onset preeclampsia. 3. Pathophysiological differences between early- and late-onset preeclampsia lead to different clinical approach to patients, depending on the type of the disease, including emphasis on Doppler examination in the early-onset preeclampsia. 4. The presence or absence of placental insufficiency in pregnancy complicated by preeclampsia seems to determine the clinical course of the disease, thus allowing for an alternative classification of the condition into placental and maternal preeclampsia.

Objective: To determine the resistance index (RI) and pulsatility (PI) in the umbilical artery (UA) in prediction of abnormal fetal heart rate during labor and poor fetal outcome in term pregnancy., Material and Methods: The study included 148 patients at term in uncomplicated pregnancy Daily evaluation of blood flow in the UA was performed and PI and RI were calculated. The last value before delivery was taken for the analysis. In turn predictive value of Doppler parameters has been determined in the prediction of abnormal FHR during labor and abnormal newborn condition. Evaluation included fetal CTG parameters and newborn status based on the V.Apgar scale and acid-base equilibrium in the umbilical cord blood. Then selected parameters, characterizing pregnancy and the newborn status, with abnormal Doppler results were compared. The prognostic value of Doppler indices was assessed for selected parameters determining the course of pregnancy and abnormal fetal heart rate., Results: A poor predictive value of UA PI and RI in the prediction of abnormal fetal heart rate during labor and poor fetal outcome was found. The RI in the UA presented the highest predictive value., Conclusion: RI in the UA shows higher predictive value than PI in the detection of abnormal fetal outcome and abnormal fetal heart rate in uncomplicated pregnancy at term. However, PI as well as RI in the UA have a low predictive value for the analyzed parameters.

Unlabelled: The occurrence of the metabolic syndrome (MS) increases the cardiovascular risk in comparison with healthy subjects. The pulse pressure (pp) is an independent risk factor for cardiovascular complications. The aim of the study was to evaluate the pulse pressure in subjects with MS accompanied or not by cardiovascular diseases. Material and methods. The study comprised 104 subjects with MS aged 48.65 +/- 7.89 years--group I; 477 clinically healthy subjects aged 45.75 +/- 4.68 years--group II; 137 subjects with MS accompanied by cardiovascular diseases aged 60.05 +/- 12.77 years--group III; 94 subjects with cardiovascular diseases without MS aged 57.80 +/- 9.67 years--group IV. Metabolic syndrome was diagnosed on the basis of NCEP ATP III criteria. Increased value of pulse pressure (pp) was above 63 mmHg., Results: Increased values of pp (> 63 mmHg) were found in 20.2% subjects with MS--group I, in 7.1% clinically healthy subjects--group II, in 40.88% subjects with MS accompanied by cardiovascular diseases and in 36.17% subjects with cardiovascular diseases without MS., Conclusions: Pulse pressure is simple and helpful method in assessment of vascular changes and cardiovascular risk in subjects with MS. In subjects with cardiovascular diseases with and without MS, increased values of pulse pressure are found in similar percentage of cases.

Objectives: To evaluate the usefulness of the measurement of angles of doppler wave spectrum in systolic phase in tumor vessels in adnexal masses and potential usefulness of this parameter in differential diagnosis of these lesions., Material and Methods: The study covers 173 patients with adnexal masses found on the examination., Results and Conclusions: The mean value of the measured angles in benign lesions amounted to 65.68 degrees and in malignant lesions 87.79 degrees. Additionally the readings of pulsatility index PI and flow speed: minimal -min, maximal -max and maximal mean -Ta śr max. in examined vessels were taken into consideration. The statistically significant differences in the angle values of the two groups were noticed, although the usefulness of this single parameter in differential diagnosis of the lesions is not as helpful as usefulness of RI and PI but it is more useful than Ta min, Ta max and Ta śr max.

Unlabelled: THE OBJECTIVES: The aim of this study was to evaluate the clinical value of blood flow indicies for differentiating between benign and malignant ovarian tumours., Materials and Methods: Realisation of the aim was based on the analysis of examinations' results of 686 ovarian tumors. For each recorded blood flow wave the followind parameters of examined tumor vessels were analysed: pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV), time-averaged maximum velocity (TAMXV) and maximum and diastolic velocity (MEDV). Apart from conditional probabilities we also presented assessing areas under the ROC curves, which introducted information over practical usefulness of each test., Results: Vascular perfusion was observed in 100% of malignant tumors and 92% of non-malignant tumors. In group of patients with malignant tumors PI and RI were significantly lower; and PSV, TAMXV and MEDV were higher than in group with non-malignant tumors. (p<0.05), Conclusions: Transvaginal ultrasonography with the Doppler technique is valuable diagnostic method in preoperative differentiation of tumor malignancies. The best predictive value in analysed group was observed for PI (AUROC=o.87) and MEDV (AUROC=0.86). Similar correlation was observed for premenopausal patients. In group of postmenopausal patients the best predictive value was for RI (AUROC=0.90) and MEDV (AUROC=0.88).

Unlabelled: Chronic inflammation is a widely accepted pathophysiologic factor of development and progression of atherosclerosis. One of the most important consequences of atherosclerosis is accelerated arterial stiffness. The impact of chronic inflammation on arterial stiffness was not analyzed up to now in patients with end-stage renal disease treated with peritoneal dialysis (PD). The aim of the study was to evaluate the possible relationship between aortic pulse wave velocity (AoPWV), considered useful tool of aortic stiffness assessment and blood pressure parameters, anthropometric characteristics, pro-inflammatory cytokines and acute phase reactants in patients treated with PD. MATERIAL AND METHOSA: The study was performed in the group of 43 patients (19 F 24 M) with ESRD, in the mean age of 50.6 +/- 13.4 years and on dialysis for the mean period of 21.9 +/- 20.7 months. Pulse wave velocity was assessed using two pressure transducers placed on common carotid and femoral artery, connected with automatic processor. In all patients Tumor Necrosis Factor alpha (TNF alpha), interleukin 6 (IL-6), C- reactive protein and fibrinogen were assayed as 'markers of inflammation'. Blood pressure was also measured in the standardized conditions. Mean AoPWV equaled 10.7 +/- 2.1 m/s. Significant correlations were found between AoPWV, age, body weight and BMI. AoPWV was associated with systolic blood pressure, mean arterial pressure and pulse pressure., Results: Significant correlations between AoPWV and serum IL-6 were shown, whereas association with CRP was close to statistical significance (p= 0,053). Associations between AoPWV, age and systolic blood pressure were also confirmed by multiple regression analysis., Conclusion: Chronic, uremia-dependent inflammation may be one of the factors influencing aortic stiffness in patients treated with PD.

Objectives: Gestational hypertension is associated with a high morbidity for both mother and fetus. Doppler ultrasound has allowed the fetal circulation to be examined. Now it is possible to monitor the response of the fetal circulation to hypoxia., Design: The aim of this study was to determine flow patterns in fetal circulation from pregnancies complicated by gestational hypertension and intrauterine growth restriction., Materials and Methods: The investigation included 23 fetuses with signs of the gestational hypertension and intrauterine growth restriction. We evaluated cerebral-placental ratio (CPR) and pulsation index (PI) in the middle cerebral artery (MCA) and the umbilical artery (UA). We also evaluated flows in umbilical vein., Results: We observed abnormal flow pattern in all cases of analyzing fetuses. The most common abnormal flow was vein pulsation (48%)., Conclusions: All analyzing fetuses shown signs of the hypoxia. Present of the umbilical vein pulsation or decompensate of the brain sparing effect is closely related o increased perinatal mortality.

Objectives: Umbilical venous pulsation is an important sign of hemodynamic compromise, especially during fetal heart failure and asphyxia., Design: The aim of this study was to determine of the blow flow in the middle cerebral artery and the umbilical artery in fetuses with umbilical venous pulsations., Materials and Methods: The investigation included 18 fetuses with signs of the intrauterine growth restriction and umbilical venous pulsations after 28th weeks of gestation. We evaluated cerebral-placental ratio (CPR) and pulsation index (PI) in the middle cerebral artery (MCA) and the umbilical artery (UA)., Results: We observed brain sparring effect in all cases of analyzing fetuses. There were 77,8% of abnormal flow pattern in umbilical artery. 13 fetuses had a single pulsation pattern in umbilical vein and another 5 had double pulsation pattern., Conclusions: The coexistence of umbilical vein pulsation and abnormal flow pattern in umbilical artery is closely related to increased perinatal mortality.

Objectives: Aim of research was estimation of correlation between doppler parameters and fetal state after delivery., Material and Methods: One hundred fifty-one pregnancies treated in Dept. of Obstetrics and Gynecology of Medical Academy in Bydgoszcz was investigated between 1998-2002. Pregnancies were estimated between 27 and 43 Hbd. Ultrasound examination using pulse and color Doppler was performed (ACUSON XP 128) and PI, RI, S/D, MCA, UA were estimated., Design: Following doppler parameters were analyzed: pulsatile index (PI), resistance index (RI) and systolic/diastolic ratio (S/D) in middle cerebral artery (MCA) and in umbilical cord artery (UA). The newborn children were estimated by Apgar score in first minute of life (AP1). Correlation between amount of amniotic fluid index (AFI) and newborn state in first minute after delivery was investigated too., Results: There were following correlations in this investigation: (1) negative between UA PI and AP1 (-0.26); (2) negative between UA RI and AP1 (-0.23); (3) negative between UAS/D and AP1 (-0.16); (4) negative between AFI and API (-0.06); (5) lack of statistical correlation between MCA PI, MCA RI, MCA S/D and AP1. We considered following covariancies: (1) negative between AFI and AP1 (-1.03); (2) negative between UA S/D and AP1 (-0.42); (3) negative between UA PI and AP1 (-0.23); (4) negative between UA RI and AP1 (-0.09)., Conclusions: We concluded that Doppler investigations by measure of parameters of blood flow in umbilical cord artery (PI, RI, S/D) can be predictive to fetal threat and useful in estimation of newborn state.

Aim of the Study: To verify the model of CSF circulation for both the increasing and decreasing CSF pressure during and after the infusion test., Material: Computerized infusion tests of 27 patients diagnosed for communicating hydrocephalus in the Department of Neurosurgery, Medical University of Warsaw were analyzed., Method: Pressure-volume (P-V) curves were plotted separately for ascending and descending phases of the test for comparison purposes., Results: The phenomenon of significant change of the P-V curve slope after the infusion was identified in 70% of tests. It was found that the elastance coefficient was significantly greater during the infusion than after the infusion. The pulsatile changes in cerebral blood volume were higher after the infusion in comparison to values during the infusion. The baseline pressure was higher than that before the infusion. There was a significant increase in mean arterial blood pressure after the infusion and it was not associated with any change in the heart rate., Conclusions: We hypothesized that vasogenic component of intracranial pressure is responsible for the change of P-V curve slope. We also presume that the higher value of the pressure after the infusion can be due to by the excessive accumulation of cerebrospinal fluid in the intracranial space, including extra cellular parenchymal space. Both hypotheses require further studies to be evaluated.

Objective: The aim of this study was to investigate the cerebral circulation in pregnancy complicated with oligohydramnios., Materials and Methods: Comparative clinical studies evaluated Doppler curve middle cerebral artery separately in proximal (basal, MCA-P) segment and distal (cortical, MCA-D) anatomical segment. Doppler velocity waveforms analysis was performed on the base of systolic (Vs), mean (Vm) and end-diastolic (Ved) velocity of the blood wave, systolic/diastolic ratio (S/D), resistance index (RI) and pulsatile index (PI). Results were compared in the group with oligohydramnios (15 pregnancies) and the group with normohydramnios (15 pregnancies)., Results: We found statistically significant correlation between S/D MCA-P, S/D MCA-D, RI MCA-P. Other parameters did not show statistically significant differences. Especially we did not find statistically significant differences of parameters of the fetal cerebral circulations between pregnancies with oligohydramnios and with normohydramnios., Conclusions: On the basis of this correlation, the following conclusions were drawn: 1/ pregnancies complicated with oligohydramnios do not change fetal cerebral circulation, 2/ idiopathic oligohydramnios does not qualify for group of high risk pregnancy.

Intrauterine growth restriction is associated with higher rate of complications occurring during pregnancy and in labour, increased morbidity and mortality rate in neonatal period, impaired psychosomatic development in childhood and increased susceptibility for particular diseases in adulthood. For improvement of perinatal outcome it is essential to establish objective criteria based on biophysical surveillance methods for prediction and prophylaxis of adverse outcome in IUGR pregnancies. The aim of the study was to compare selected biophysical surveillance methods in prediction and prophylaxis of complications associated with adverse pregnancy outcome in intrauterine growth restriction. There were statistically significant differences in CTG, BPS, AFI, and pulsatile index values in umbilical artery and MCA between IUGR and normal fetuses. The best predictor of adverse pregnancy outcome in IUGR fetuses was PI value in umbilical artery.

Purpose: To determine blood-flow parameters in extraocular vessels in patients with primary open-angle glaucoma before and after trabeculectomy., Material and Methods: Between November and December 2002 in 18 patients (12 women and 6 men) with primary open-angle glaucoma trabeculectomy was performed. In preoperative period, 10 days after and between third and sixth month after trabeculectomy, patients were subjected to complete ocular examination and evaluation of blood flow velocity (mean, systolic, diastolic) and pulsation indexes in posterior ciliary arteries with Doppler focused pulsating ultrasonography. Based on the results of the last examination patients were divided in two groups before the treatment. Group A included 9 patients (4 men and 5 women), age ranged from 46 to 77 (mean 63.67). Preoperative IOP in this group ranged from 14.6 mmHg to 34.5 mmHg (mean 25.6 mmHg). Blood-flow velocities were lowered in 9 patients for 20% below the norm. Pulsation indexes ranged from 1.0 to 1.3 in 7 patients and from 1.3 to 1.5 in 2 patients. Group B included 9 patients (6 women and 3 men) age ranged from 58 to 88 (mean 73.5). Preoperative IOP in this group ranged from 14 to 44 mmHg (mean 27.24 mmHg). Blood-flow velocities were lowered in 9 patients for 30-50% below the norm and pulsation indexes were higher then 1.2. Three of the 9 described patients had no velocities in diastolic phase and pulsation indexes were higher than 2.0., Results: Postoperative IOP in group A ranged from 7.1 to 17.3 mmHg (mean 11.0 mmHg). Four of the 7 described patients had velocities higher for 20-30% than preoperatively and were normal. Pulsation indexes lowered to 1.0-1.2. In 3 patients velocity increase was observed later (after 6 months). In group B postoperative IOP ranged from 4.9 to 14.6 mmHg (mean 8.6 mmHg). Velocity increase was observed and it reached the lower limit of the norm or were higher. Pulsation indexes lowered to 1.0-1.2., Conclusion: The parameters of blood-flow in posterior ciliary arteries improved in all cases after trabeculectomy.

Purpose: To compare ocular blood flow in patients with glaucoma juvenile and in normal subjects., Material and Methods: 20 glaucoma juvenile subjects and 20 persons as a control group aged 13 and 17, were matched for intraocular pressure and pulsatile ocular blood flow using pulsatile ocular blood flow (POBF)., Results: A positive correlation was found between ocular blood flow in patients with glaucoma juvenile and normal subjects., Conclusions: 1) POBF is a new and simple tool for the measurement intraocular pressure and pulsatile ocular blood flow and may be useful for diagnosis of the glaucoma. 2) We found a significant difference between ocular blood flow in glaucoma juvenile patients and normal subjects.

Objective: The aim of our study was to compare ultrasound vascular blood flow indices with the expression of CD-34 in women with benign and malignant adnexal tumors., Materials and Methods: Transvaginal color and pulsed Doppler sonography was performed before surgical procedure in 105 women with adnexal tumors. Blood flow indices: pulsatility index (PI) and resistive index (RI) in blood vessels with the highest flow velocity were measured within each tumor. Immunohistochemical analysis of microvessel density (MVD) was performed on representative highly vascular tumor specimens fixed in 10% formalin and paraffin embedded. The primary monoclonal mouse anti-human CD-34 antibody (1:25, DAKO, Denmark) was used. Statistical calculations included group comparison with Kruskal-Wallis ANOVA on ranks and correlation analysis (Statistica for Windows 6.0, Statsoft Poland)., Results: Mean age of the studied women was 55.6 +/- 11.5 yrs. Of 104 tumors, 35 (33.6%) were benign and 69 (66.4%) were malignant. The latter included 14 FIGO stage I cases. Low resistance or pulsatility indices (RI < 0.5 or PI < 0.8) were found in 58 of 69 (84%) malignant masses and in 21 of 35 (60%) benign tumors. Substantial overlap in measured indices was found between both studied groups. Median number of microvessels per high power field in the benign and malignant tumors were 37 (range: 14-156) and 68 (range: 25-177), respectively. These differences were statistically significant (p = 0.007, Mann-Whitney U test). Also, a significant correlation was found between MVD and low resistance to blood flow as measured by the PI or RI (r = 0.43, p < 0.05). However, no statistically significant differences in MVD were found between FIGO stage I and other stages of ovarian cancer., Conclusion: Low resistance to blood flow as measured by the resistive or pulsatlity indices used in color Doppler sonography may by positively correlated with the microvessel density in the malignant ovarian tumors.

Unlabelled: For many years now Doppler's ultrasonography has been broadly applied in ophthalmology. Recently it has been communicated, that there is a possibility of assessing the disorders of retinal circulation in the process of retinal detachment., Purpose: Our research had to establish, whether after the scleral buckling treatments executed due to the retinal detachment, there is a change in the blood flow in the vessels of the eyeballs., Material and Methods: The observations were conducted in 30 eyes of 15 people, who were diagnosed with opening-related retinal detachment. The colour Doppler's ultrasonography was performed by using ATL Ultramark 9HDI apparatus with a linear sound of the frequency range from 7.5 to 10 MHz. The anatomic structures of the eye socket in the transverse and arrow plane were assessed. The flow spectrum was measured according to the PD method (pulsating Doppler) in the central artery of the retina at the distance of approximately 2-4 mm from the optic disc and in the ophthalmic artery. The analysis of the spectrum allowed one to determine the values of the pulsation indexes-PI, and resistance indexes-RI, in the ophthalmic artery and in the central artery of the retina of the healthy eye, and of the eye with detached retina 2-3 days before and in 5-7 days after the operative procedure., Results: After radial and circumferential buckling treatments, the conducted research found no increased resistance of the flow in the arteries, namely: the central artery of the retina and the ophthalmic artery. The condition for the maintenance of the correct parameters of the blood flow was the intraocular pressure. At the same time, in the eyes with detached retina, the decrease in the resistance of the flow in the ophthalmic artery was observed, which was being brought back to normal after the operative treatment.

Objective: The purpose of the study was to compare usefulness of color doppler technique and measurements of Ca 125 and TPA levels in differential diagnosis of adnexal masses., Material and Methods: 122 patients admitted and diagnosed due to presence of adnexal masses. Transvaginal scans with color doppler technique were performed Ca 125 and TPA levels in blood serum were measured. Morphological features of tumor during transvaginal scans were also noticed. Histopathological data after operation were collected and compared with preoperative scores., Results: 22 adnexal masses were malignant. Presence of central vascularisation within the tumor and low Resistance Index and Pulsatility Index values were the best predictors of malignancy. Measurements of Ca 125 and TPA levels had worse predictive value ind diagnosis of adnexal masses., Conclusions: Color doppler technique is a useful tool in diagnosis of adnexal masses and has higher sensitivity and specificity compared with measurements of Ca125, TPA levels and single tumor features achieved during transvaginal ultrasound.

Objectives: The aim of the study was to determine the values of i.e. resistance index (RI) and pulsatility index (PI) in the spiral arteries and to evaluate the maternal serum concentration of progesterone trying to find correlation between these parameters in the group of patients in early pregnancy complicated by threatened abortion., Study Methods: We have analysed 30 pregnant women between 5th and 12th weeks of pregnancy with the symptoms of vaginal bleeding & lower abdominal pains diagnosed as threatened abortion. In all patients transvaginal ultrasound examination with pulse color Doppler was performed. The RI and PI values were calculated for blood flow velocity waveforms obtained from the spiral arteries. The concentration of progesterone in maternal serum was evaluated by Microparticle Enzyme Immunoassay. The correlation between analysed parameters and pregnancy duration was examined with use of linear correlation by Pearson. The correlation between Doppler and biochemical parameters were analysed with use of rang correlation method by Spearman., Results: Thirty flow velocity waveforms from spiral arteries were analysed and blood flow indices were calculated. We have found statistically significant negative correlation between the values of both blood flow parameters (RI & PI) and successive weeks of pregnancy (p < 0.001) and statistically significant positive correlation between maternal serum concentration of progesterone and pregnancy duration (p < 0.05). In the tested group in 40% of patients the level of progesterone was abnormal. We have not find any correlation between serum progesterone concentration and doppler parameters in our study., Conclusions: There is observed the characteristic drop of resistance to the blood flow in the vessels of the uteroplacental circulation in the successive weeks of early pregnancy in patients with threatened abortion similar to normal early pregnancies. Lack of correlation between maternal serum concentration of progesterone and blood flow parameters indicates that other hormonal factors play major role in the regulation of the blood flow in these vessels in early pregnancy. Only the combination of Doppler blood flow analysis in spiral arteries and progesterone evaluation in the maternal serum performed in first trimester may be useful for the intensive fetal monitoring of high risk pregnancies.

A case of team-treated thrombosed popliteal artery caused by blunt limb trauma with open tibia fracture is presented. Thrombosed artery was treated by endovascular pulse-spray method using Angiomed catheter. Implementation of this method allowed us to dissolve thrombus and to retrieve arterial circulation in the limb. In our opinion this procedure was an alternative for traditional surgery. After revascularisation of the limb orthopedic operation on fractured bones was performed using Zespol technique.

The aim of the study was the evaluation of the clinical usefulness of transcranial Doppler ultrasonography /TDU/ in patients with vascular dementia. The study was carried out in a group of 69 patients divided into two groups: group i of 32 patients aged 45-78 years, mean age 58.4 years with two or more ischaemic foci on TDU and dementia symptoms. The cases in this group fulfilled the criteria of dementia according to DSM-IV, ICD 10, MMS scale and Hachinski ischaemic scale. In TDU the following parameters were analysed: maximal velocity /Vmax/, minimal velocity /Vd/, mean velocity /Vmean/ of blood flow in the middle cerebral arteries, pulsation index /PI/ and resistance index /RI/. In group II the patients were divided into three subgroups according to ICD-10 criteria and localization of ischaemic foci: with cortical, subcortical and mixed lesions. The following conclusion have been drawn: 1/ the parameters of TDU could serve for differentiation of patients with vascular dementia; 2/ the PI and RI parameters in TDU are most valuable for diagnosis establishing; 3/ the transcranial Doppler ultrasonography is insufficient for differential diagnosis of dementia.

Purpose: The aim of this study was to establish the normal values of blood flow velocities in ophthalmic and central retinal vessels., Patients and Methods: 29 healthy subjects: 18 men and 11 women, mean age 55 +/- 20 years, were examined in Color Doppler technique with spectral analysis with the 7.5 MHz linear transducer. The peak systolic, end diastolic and mean flow velocities were measured. The resistance index (RI) and pulsatility index (PI) were also estimated., Results: The values of velocities are comparable with results of other authors, especially when the similar frequency of the transducers was used. No significant differences of flow parameters were found between genders and right and left eyes when comparing the means. Ophthalmic artery velocities significantly declined as a function of age, but the RI and PI indices were similar. There were age-related differences between flow parameters in central retinal vessels., Conclusions: Ultrasound system characteristics, methodology of the examination and age factor should be considered in clinical evaluation of orbital vessels with color Doppler imaging.

Unlabelled: The aim of the study was estimation of some blood flow parameters in arteries of both forearms in patients with "sleeve" arterio-venous fistula (AVF) created for hemodialysis. From 1988 to 1996 145 radio-cephalic AVF's with "sleeve" anastomoses were created in our Department. Duplex-Scan examinations were performed in 30 patients aged from 22 to 68 years. There are 15 women and 15 men with primary AVF lasting over 12 months. The B&K Medical System 3535 with 7.5 MHz transducer was used for all measurements. Diameter of radial artery (TP) in forearms with AVF fistula was on average 4.7 mm, and in ulnar artery (TL) 2.6 mm. In forearms without AVF diameters were, respectively 2.4 mm and 2.3 mm. Volume flow in forearms with AVF was in TP 1056, and in TL 169 ml/min. In forearms without AVF these flows were 59 and 63 ml/mm, respectively. Resistance index in forearms with AVF was 0.29 in TR and 0.47 in TL, however in forearms without AVF 0.76 in both arteries. Pulsatility index on the side of AVF was 0.8 in TR and 1.8 in TL, however on the side without AVF 4.1 in both arteries. These differences were statistically significant., Conclusions: 1. In arteries of forearm with AVF diameter and volume blood flow increases, however resistance and pulsatility indices decreases. 2. Volume flow in ulnar artery in forearms with AVF is similar to flow in both arteries in forearm without AVF.

Unlabelled: The aim of the study was to evaluate blood flow rate by means of Doppler pulsating ultrasonography focused in internal carotid artery, opthalmic artery and posterior ciliary arteries in patients with different types of retinal veins occlusion. The material included 8 patients with congestive venous retinopathy, 27 with ischaemic central retinal vein occlusion and 35 with central retinal vein branch occlusion. The flow measurements were performed using ultrasound 3-D trans Scan of EME company., Results: Patients with ischaemic occlusion revealed statistically significant decrease of blood flow rate in opthalmic artery and posterior ciliary arteries on the ill eye side. Moreover, these patients had the worst course of the disease, including permanent sight defect, ischaemic complications in the funds of the eye and in fluorescein angiography. Flow measurements confirmed the role of arterial flow insufficiency in formation and clinical course of retinal vein occlusion and in development of complications.

The purpose of the study was to estimate blood flow in uterine arteries in patients with uterus cervix invasive carcinoma. In the study the colour Doppler ultrasonography was used. It was found out that in the group of patients with uterus cervix carcinoma pulsation index (PI)--1.82 +/- 1.44 as well as resistance index (RI)--0.72 +/- 0.12 are statistically significantly lower than adequate indices in the control group (PI)--3.36 +/- 1.04 and (RI)--0.81 +/- 0.17 (p < 0.05).

Intravenous treatment with megadoses of glycocorticoids was used in 8 children with juvenile dermatomyositis (JDM). Methylprednisolone (Mp-Solu-Medrol) was administered in a dose of 20 mg/kg, not exceeding 1 g, in the form of drop infusion over a period of 1.5-2.5 hours. An initial 3-6 consecutive day course of intravenous pulse was followed by further treatment twice a week for 2 to 5 weeks. A good response this therapy was observed in all of the children. However the best results were obtained in those patients who had not been treated previously and in when MP pulses were given soon from the onset of the disease (group I). MP pulse therapy administered in patients nonresponsive to conventional treatment (group II) did not prevent further relapses. When the treatment was introduced at the later, exacerbated stage of the disease, none of the patients entered into remission (group III). No side effects were observed during the pulse therapy. This study confirms the efficacy of MP pulse therapy in JDM, specially in the early severe stage of the disease.

The authors presented results of research on pathological vascularization in ovarian tumors by Doppler's method. 60 records of blood flow were analysed to estimate: pulsation index (PI) and resistance index (RI). Among benign ovarian tumors (26 cases) PI was 1.82 +/- 0.93 and RI 0.93 +/- 0.36. On the contrary, for malignant neoplasms (11 cases) the blood flow was low resistance PI: 0.89 +/- 0.38 and RI: 0.44 +/- 0.19.

The aim of this study was the evaluation of blood flow factors prognostical value in differentiation of malignancy among ovarian tumors--sensitivity of this method was 81.8--90.9%, specificity was 88.5%, positive predict value 75.0--76.9% and negative predict value 92.0--95.8%. It was stated that Dopplers method is very usefull in diagnosis of malignant ovarian neoplasms. Moreover it was shown that pulsation index (PI) is more suitable than resistance index (RI), particularly in preoperative diagnostics.

The aim of the work was an attempt at answering the question whether there is any correlation between the haemodynamic indices describing arterial elasticity assessed by physical analysis of the circulatory system and lipid risk factors for arterial atherosclerosis in boys aged 15 to 18 years. The studies included 45 boys with lipid risk factors for atherosclerosis. The control group included 53 boys without lipid risk factors. In boys aged 17-18 years with lipid risk factors for atherosclerosis as compared with their peers with normal serum lipid level, a statistically significant change of arterial elasticity was found. A positive correlation was also found between the increased serum cholesterol level and the values of air-chamber elasticity index and peripheral vascular resistance, and a negative correlation was demonstrated between the decreased serum HDL-cholesterol concentration and the increase of pulse wave velocity in the aorta, air-chamber elasticity index and peripheral vascular resistance.

Normal values of the pulsatility index in the fetal renal arteries in a group of 65 uncomplicated pregnancies were established. The measurements were obtained between 28 and 40 weeks of gestation. The values of pulsatility index may be used as a reference for further investigation of pathologic pregnancies.

Graafian follicle growth and development and Doppler flow analysis of blood vessels in the wall of the follicle, was analyzed. Twelve patients with primary infertility were observed between days 12 to 15 of the cycle. Analysis of resistance index (RI) and pulsatility index (PI) of the wall vessels was performed. Statistically significant difference in RI and PI indices in preovulatory and post-ovulatory period was observed.

The speed of blood perfusion and the pulsation curve in ciliary arteries was checked by the method of Doppler's pulsating focused ultrasonography in 30 patients aged 46-78 years treated for glaucoma and diabetes. The data obtained were compared with analogical data in nondiabetic patients with glaucoma. It was established that the increase of the intraocular pressure caused a larger and earlier impairment of the regulating mechanism of the ciliary microcirculation in diabetic patients with glaucoma in comparison with the group of glaucomatous patients without diabetes. Particularly high values of pulsation indexes for ciliary arteries were observed in eyes with glaucoma and with diabetic changes rated as the fifth group of diabetic changes.

The velocity of blood perfusion and pulsation curve in posterior ciliary arteries was evaluated in 180 patients (476 eyes) with primary glaucoma, aged 22 to 81 years. The investigations were carried out by Doppler's focused pulsating ultrasonographic method with probes of 2 and 8 MHz frequency connected with a TC-2-64 apparatus (made by EME of German Federal Republic). The blood perfusion in the posterior ciliary arteries was compared with the changes in the visual field, in the aspect of the optic disc in patients with primary glaucoma and various levels of the IOP. In patients with primary glaucoma and advanced fundus changes (of 2-nd and 3-rd grade) the mechanisms of regulation of the ciliary circulation were normally functioning for quite a long time. In the period of breaking down of the mechanisms the changes in the visual field came into being.

One hundred and ten examination were performed in 71 patients with primary glaucoma aged 21-81 years (217 eyes). The blood perfusion speed in the ophthalmic artery was measured in each patient by the ultrasonographic pulsating Doppler's method with a probe of a 2.0 MHz frequency by means of a TC-2-64 apparatus of EME production. The ophthalmic artery was examined by transorbital technique according to Spencer and Whisler on a 40-50 mm depth. The examined orbits were divided into 4 groups in dependence of the grade of the optic nerve atrophy. A lowering of over 50 per cent of the blood speed (below 10 cm/s) was found in 10.6 per cent of the eyes. Optic atrophy of the 3d and 4th grade was revealed in 70 p.c. of these eyes; the intraocular pressure remained in normal limits.

One hundred and thirty two examinations (253 eyes) were performed in 78 patients with primary glaucoma, 21-81 years of age. The blood speed and pulsation curve in the posterior ciliary arteries were evaluated by the ultrasonographic pulsating focused Doppler's method with a probe of 8 MHz frequency, connected to the TC-2-64 apparatus of EME production in eyes with a various grade of the optic nerve lesion and by various values of the IOP. It was shown that in eyes with early glaucomatous changes of the optic nerve the correct perfusion in the ciliary circulation is secured in the presence of a rise of the IOP up to 34 mm Hg. Instead in eyes with an advanced optic atrophy a normal perfusion in the ciliary arteries persists only when the IOP is lower than 15 mm Hg.