[Thrombolytic therapy and percutaneous transluminal coronary angioplasty in acute myocardial infarct].

J Sochman, J Fabián

Vnitr Lek 1989, 35(10):937-944

The authors analyze contemporary views on the position of thrombolytic treatment and percutaneous transluminal coronary angioplasty in the treatment of acute myocardial infarctions. The justification of different procedures is based on the final effect of treatment on the mortality of patients, on left ventricular function and behaviour of the residual stenosis in different groups of patients. The authors define risk groups of patients which can justify the application of specific therapeutic procedures. In the conclusion they try to define general indications for different types of treatment.

[The effect of temporary cardiac stimulation on the course of acute myocardial infarct].

M Soucek, Z Lupínek

Vnitr Lek 1989, 35(10):945-951

The authors analyzed retrospectively the course of acute myocardial infarction in 165 patients, who needed temporary pacing. Medicamentous influencing with Atropine was not very effective and isoprenaline influencing with atropine was not very effective and isoprenaline was used only to brigade the time before the electrode was introduced. From the whole group, 36 patients were selected who had been admitted to the coronary unit within 4 hours after the development of pain. The authors investigated the development and regression of impaired conduction and investigated whether early admission, early diagnosis of bradyarrhythmia and early introduction...

[Diastolic function of the hypertrophic left cardiac ventricle in hypertensive patients evaluated with Doppler echocardiography].

R Spacek, P Niederle, A Stárek, I Hes, P Kozák

Vnitr Lek 1989, 35(10):952-958

The authors examined by Doppler and one-dimensional echocardiography 20 patients with concentric hypertrophy of the musculature of the left ventricle and hypertension and 20 healthy subjects of similar age. As compared with the control group, they found in all patients deterioration of indicators of left ventricular diastolic function. The rate of blood flow in the early diastolic phase (Ev) was reduced and the ratio of the atrial contraction (Av) in the filling of the left ventricle increased (p less than 0.001). The maximal blood flow across the mitral orifice in early diastole (PFR) was lower (p less than 0.05) and the slowing down of the early...

[Sensitivity and specificity of programmed stimulation of the cardiac ventricles].

M Pleskot, P Tilser, V Pidrman

Vnitr Lek 1989, 35(10):959-966

The authors used programmed pacing of the ventricles in a total of 55 subjects (41 men and 14 women). In a group of 36 patients with chronic relapsing ventricular tachycardias they assessed the sensitivity of this method as 83.3%. In 19 subjects without serious organic heart disease and without clinically confirmed tachyarrhythmias programmed pacing of the ventricles did not reveal diagnostic ventricular tachycardias. The specificity of the method was 100%. The highest detection rate of diagnostic ventricular tachycardias was obtained when four extrastimuli were applied during the sinus rhythm and 2-4 extrastimuli, using the basic stimulation rate...

[Gemfibrozil in the treatment of hyperlipoproteinemia].

R Ceska, J Sobra

Vnitr Lek 1989, 35(10):967-971

Within the framework of clinical tests of the preparation Gevilon (gemfibrosil tablets 450 mg) of Parke-Davis Co. this hypolipidaemic preparation was administered to 28 patients with different types of hyperlipoproteinaemia. One-month administration of gemfibrosil, 900 mg per day, significantly influenced some parameters of the lipid and lipoprotein metabolism. Plasma cholesterol declined by 20%, triglycerides by as much as 60%. On the other hand, the HDL cholesterol level did not change. The concentration of the "risk" apolipoprotein B declined by 11%, that of apolipoprotein A1 which is considered protective from the aspect of ischaemic heart disease...

[Adverse effects of hemapheresis].

M Bláha, L Jebavý, O Siroký, J Malý, M Pecka

Vnitr Lek 1989, 35(10):972-981

The authors performed 1252 haemaphereses, incl. 689 plasmaphereses. They divide the side-reactions as follows: Technical reaction: these do not threaten the donor directly; these reactions were recorded in 4.4%. Clinical reactions--total 6.8%. a) early, b) late. The authors recorded one severe reaction during plasmapheresis, there was however, no fatality. The most frequent reactions were: general symptoms, failure to withdraw blood because of poor state of the veins and hypotension. The authors analyze the importance of the observed reactions. They used continual separators where in general the incidence of reactions is smaller. They investigated...

[The effect of blood platelet freezing on their antigen activity].

M Vopatová, A Májský, J Suttnar, J Dyr

Vnitr Lek 1989, 35(10):982-986

The authors investigated the effect of freezing of platelets after addition of various cryoprotective substances (glycerol, dimethyl sulphoxide and hydroxyethyl starch) on the preservation of some antigenic properties of these blood cells. It was revealed that during freezing of platelets in 5% glycerol and 4% hydroxyethyl starch no change of the specific antigen Kob and of HLA antigens occurred. Freezing in dimethylsulphoxide, however, weakened the activity of some antigens; usually this applied to antigen Kob, in HLA antigens it was rather an exception. From the results ensues, however, that in the transfusion practice it is important to foresee...

[The effect of cytomegalovirus and Epstein-Barr virus infection on immunologic signs].

L Korcáková, J Vrubel, J Kaslík, M Nozicková

Vnitr Lek 1989, 35(10):987-991

Patients with active CMV or EBV infection characterized by the presence of specific serum IgM and/or high immunofluorescence in IgG, have higher levels of circulating immune complexes and a lower phagocytic activity of leucocytes than patients with latent CMV/EBV infections or not infected patients. In active infections at the same time the absolute number of lymphocytes with the surface sign CD8 increases. The amount of lymphocytes with differential antigens CD3 and CD4 does not change substantially. Also the levels of the third and fourth component of complement and C-reactive protein remain within the normal range.

[Incidence of chronic gastritis in young patients with functional dyspepsia].

M Sorf, M Gogora, V Krislo

Vnitr Lek 1989, 35(10):992-997

The authors made during a 16-month period in 226 patients the diagnosis of functional gastric dyspepsia (144 women and 82 men aged 20 to 50 years). The differentiating criterion was a pathological organic finding in the upper part of the digestive tract, a pathological finding on the liver, gallbladder and pancreas as well as a pathological laboratory finding. The probands were divided by age into two groups and compared with a control group with similar differentiating criteria; however, the latter had no dyspeptic complaints. The differences in the incidence of chronic gastritis were not significant. From the investigation the following conclusions...

[The effect of Sinecal fiber on compensation in type 2 diabetics].

J Perusicová, P Fric, V Cacáková, I Mardesicová, P Stolba, P Kocna

Vnitr Lek 1989, 35(10):998-100

The authors investigated in 28 type 2 diabetics the effect of addition of 21 g Sinecal fibre to the normal diet on the glucose and lipid metabolism. The value of C,peptide was significantly influenced after breakfast and a single dose of Sinecal. The other investigated parameters (blood sugar on fasting and after a meal, glycosuria, glycosylated proteins, C-peptide on fasting and after a meal, triacylglycerol and cholesterol) were not influenced by a single nor by long-term intake of Sinecal. Further development of fibre preparations with better tolerance and a greater effect on the glucose metabolism is desirable.

[Myxoma of the left ventricle. Indications for cardiosurgery without invasive examination].

J Hůla, J Mastálka

Vnitr Lek 1989, 35(10):1006-1011

Two-dimensional echocardiographic examination in patients with myxoma of the left atrium is the basis of reliable diagnosis and is satisfactory as regards visualization and functional aspect for the final indication for a radical surgical operation. Myxoma of the left atrium is thus one of the heart diseases where we do not need preoperative invasive diagnostic examinations for indication of cardiosurgery.

[Arrhythmogenic dysplasia of the right ventricle].

P Vojtísek, I Steiner

Vnitr Lek 1989, 35(10):1012-1016

The authors describe a case of sudden death of a 22-year-old man where on necropsy arrhythmogenic dysplasia of the right ventricle was found. The authors describe the clinical and morphological picture of this recent nosological unit. They discuss its relationship with Uhl's anomaly. Attention is drawn to concurrent affection of the left ventricle.

[Empyema--a rare type of pulmonary disease in rheumatoid arthritis].

S Alusík, S Havel, M Valesová

Vnitr Lek 1989, 35(10):1017-1019

In 52-year old patient with rheumatoid arthritis a massive empyema without development of pyopneumothorax was found. The authors discuss the mechanism of development of the empyema, its type and treatment.

[The development of myocardial infarct in a patient treated with 5-fluorouracil].

J Murín, J Kasper, J Danko, M Cerná, J Bulas, R Uhliar

Vnitr Lek 1989, 35(10):1020-1024

The authors describe the first case of myocardial infarction in their department which occurred during 5-fluorouracil treatment. In a 37 year-old patient two years before the infarction an epidermoid carcinoma of the lower lip was found. The patient was subjected to operation and radiotherapy. Because of a relapse of the process after one year the patient was re-operated with subsequent chemotherapy (vincristine, methotrexate, cis-platinum). Because the effect was not satisfactory, after another year 5-fluorouracil treatment was started (i.v. infusion of 3000 mg in two days). In the course of the infusion the patient developed the clinical picture...

[Acute myocardial infarct and the kinetics of creatine kinase].

J Sochman, J Fabiían, M Englis, A Belán

Vnitr Lek 1989, 35(10):1025-1032

The authors criticize contemporary views on creatine kinase kinetics in relation to the patency or occlusion of the coronary artery in the area of the infarction focus. In the investigation proper the time needed to achieve the peak plasma creatine kinase activity after the onset of infarction pain in patients with necroses in different areas of the left ventricle is assessed. Although the interpretation of the observed phenomenon is not clear so far, this finding makes the informative value of the hitherto used time parameter of the kinetics of this enzyme doubtful, in particular in thrombolytic treatment of myocardial infarction. In practice it is...

[Acute eosinophilic leukemia].

V Koza

Vnitr Lek 1989, 35(10):1039-1040