[Agreement analysis of the results of examinations performed by a physician and automated results in the preventive care system].

L Scheidová, I Horský, J Tkácik, V Mongiellová, L Bachárová, L Smolák, N Plevová

Vnitr Lek 1989, 35(9):833-837

The authors elaborated an automated preventive system and examined by means of it 1000 probands with regard to the incidence of cardiovascular and bronchopulmonary diseases and analyzed the results. In the submitted paper they present the results of an analysis of agreement of conclusions of examination made in the traditional way by the doctor and those obtained in the automated diagnostic preventive system. Agreement in the sense of a positive statement (presence of disease) was recorded in 54.1%, agreement in the sense of a negative finding (disease not detected) was recorded in 28.7%. Falsely negative conclusions (the doctor detected the disease,...

[Evaluation of the Q wave in leads II, III and aVF. II. Impulse conduction disorders , hypertrophy of the cardiac muscle, pre-excitation, focal and diffuse changes in the cardiac muscle and other causes].

S Cagán, L Kuchárová, S Filipová

Vnitr Lek 1989, 35(9):838-845

The authors present a brief account of contemporary findings in the literature on the evaluation of the Q wave in the electrocardiogram in leads II, III and aVF in disorders of the conduction of impulses (also combination with focal lesions of the heart muscle), in preexcitation of various extent, in hypertrophy and different focal and diffuse changes of the heart muscle. They mention briefly also other cardiac and extracardiac causes of the development and persistence of the Q wave in leads, II, III, aVF. They reached the main conclusion that isolated evaluation of this phenomenon only from the electrocardiogram can lead to erroneous conclusions,...

[Urinary excretion of catecholamines by the transplanted kidney].

J Stríbrná, Z Placer, J Hrabáněová, V Kocandrle, V Lánská, V Reitschlägerová

Vnitr Lek 1989, 35(9):846-851

In 88 patients after kidney transplantation (Tx) and in 30 healthy volunteers the urinary adrenaline, noradrenaline and dopamine excretion in 24 hours was examined. The results were calculated per values of glomerular filtration rate (Ccr). In patients after Tx an increased adrenaline excretion was found and its relative predominance over noradrenaline in urine, as it is the case in renal insufficiency. The absolute reduction of noradrenaline excretion was, when calculated per Ccr values, proportional to the number of functional nephrons. The absolute dopamine excretion was proportional to Ccr values and when calculated per glomerular filtration rate...

[Diagnosis and classification of tubulointerstitial nephritis].

I Slugen, M Pavlovic, A Kovác, M Pauer, K Furková, P Fiala

Vnitr Lek 1989, 35(9):852-858

To make a correct diagnosis of tubulointerstitial nephritis and to make it in time calls for knowledge of its clinical symptomatology (it is usually very marked in acute forms and in chronic forms it is frequently inapparent) and it is essential to know the main causes which produce this type of renal damage. In some instances the already developed disease is diagnosed and not infrequently even renal failure. Recognition of the aetiological and pathogenetic multiplicity of the disease, as made possible by the submitted classification of the WHO expert commission, is one of the prerequisites of the diagnosis and treatment in time or of prevention by...

[Morphology of tubulointerstitial nephritis].

I Slugen, M Pavlovic, M Pauer, D Danis, F Dorociak, A Kovac

Vnitr Lek 1989, 35(9):859-863

The morphological picture of interstitial (tubulointerstitial) nephritis is not rare when renal biopsies or necropsies are evaluated. According to experience assembled during examinations of renal biopsies (a group of 1484 biopsies) in particular biopsies with morphological changes of the character of interstitial nephritis (144 in the group) and according to findings reported in the available literature, the authors submit an account of changes encountered in a large group of interstitial nephrites. The need of such an account ensues in particular from clinical practice where the morphological picture can be decisive for establishing the correct diagnosis...

[Plasma proteins and other substances in membrane plasmapheresis. Relation to possibilities and limitations of this therapeutic method].

K Opatrný, K Opatrný, P Kováríková, M Cerhová, V Cepelák, H Rusnáková, F Sefrna

Vnitr Lek 1989, 35(9):864-872

The authors investigated the effectiveness of therapeutic membrane plasmapheresis and its influence on plasma concentrations of 17 proteins, cholesterol, triacylglycerols, urea, creatinine and uric acid. To this end they made 30 operations on monitors A 2008 PF with filters Plasmaflux P 2, where they exchanged one volume of plasma and replaced it with isooncotic albumin. They assessed the plasma concentrations of the investigated substances before, in the course of and after the operation, estimated sieving coefficients during the 15th and 90th minute and the clearance. Under conditions in vivo they confirmed that the sieving coefficients of the investigated...

[Bopindolol does not affect normal glucose and lipid metabolism in hypertensive patients].

V Fedelesová, V Spustová, M Hucková, G Kovác

Vnitr Lek 1989, 35(9):873-879

The authors administered to ten patients with mild to medium severe hypertension and with a normal glucose tolerance and serum lipid spectrum bopindolol in amounts of 0.5 to 2 mg/day in the course of 12 months. They revealed: a) bopindolol reduced effectively the blood pressure with a maximum decline already during the first month, b) It reduced significantly the heart rate, c) it did not cause deterioration of the glucose tolerance and did not interfere with the response of immunoreactive insulin (IRI) after a glucose load, d) it did not influence significantly the levels of lipoprotein cholesterol, total cholesterol, VLDL cholesterol, HDL cholesterol;...

[The origin of HLA antigens in thrombocytes].

P Korínková

Vnitr Lek 1989, 35(9):880-884

When examining thrombocytic antibodies in serum of patients by the ELISA test concurrently present HLA antibodies were found only in exceptional cases (8), as compared with other tests for the detection of thrombocyte antibodies. One of the possible reasons of this finding could be the mere adsorption of HLA antigens from plasma onto the thrombocyte surface. During the set up of the ELISA test when we work with thrombocytes adhering to the surface of a polystyrene plate and not with a suspension of thrombocytes as in other tests, the spatial arrangement or change of epitopes of HLA antigen could prevent the reaction of HLA antigens with the appropriate...

[The importance of the determination of primary bile acids in diseases of the digestive tract].

E Fucíková, I Kimlová, L Kuzela, V Vísek

Vnitr Lek 1989, 35(9):885-889

The authors assessed the concentration of primary bile acids in patients with liver diseases, diseases of the gallbladder and biliary pathways, with affections of the pancreas and in a control group. Primary bile acids and their conjugated derivatives were assessed by radioimmunoanalysis from the patients' serum, using radiodiagnostic sets of Farmos Co. Finland. The range of the assessed concentrations was 0.15-15 mumol/l. The total number of examined subjects was 56, blood specimens for estimation of bile acids were collected in the morning after 12 hours fasting. From the investigation ensues that primary bile acids were elevated in diseases of the...

[Diabetic osteopathies. 3. The effect of diabetic complications on bone mineralization].

J Kocián, J Brunová

Vnitr Lek 1989, 35(9):890-898

Using the method of assessment of clavicular corticodiaphyseal indices, the authors investigated the mineralization of bones in a group of 215 type II diabetics and in 40 type I diabetics. From both groups patients were selected without detectable complications and these were compared with a sub-group of patients who had some complications. Furthermore the authors investigated the number of fractures of vertebral bodies and other bones. The poorest results as regards mineralization were found in complications which interfere with calcium absorption: enteropathies, chronic pancreatitis, gastrectomies, renal disease and in women also liver disease, in...

[Residual urine and phagocytic activity of polymorphonuclear cells in diabetes].

M Sorf, V Krislo, J Bartek, S Krsák

Vnitr Lek 1989, 35(9):899-902

The authors examined by ultrasonography the residual urine in 105 diabetics after passing urine (55 men--53.3% and 49 women--46.7%) aged 20 to 50 years and compared the results with a control group of 103 non-diabetics selected at random (55 men--48.7% and 58 women--51.3%), also aged 20-50 years. Patients with organic diseases affecting the residual urine were not included in the group. In all patients the phagocytic ratio was examined, the urine was analyzed chemically and the sediment was examined, in selected cases also cultivation examinations were 105 diabetics residual urine was found in 34 cases (34.4% and in the control group of 113 non-diabetics...

[Experience with the dipyridamole test in the diagnosis of coronary insufficiency].

J Cerný, J Kandus, P Cerný

Vnitr Lek 1989, 35(9):903-912

In 1980-86 263 dipyridamole tests were made before or after ergometry on account of the diagnosis of coronary insufficiency and possible indication for coronarography. The sensitivity and specificity was evaluated in a group of 101 subjects where both examinations had been made. As a reference method the authors used ergometry with more strict criteria of positivity of the two tests (deviations of segment ST 0.2 mV, incl. stenocardia) which are in good agreement with coronarography. The sensitivity was 58.2 and the specificity 96% (in men 61.4 and 100%). On combination of 98 dipyridamole tests with immediately following ergometry of 39 negative ergometries...

[Maximal dilatation of the coronary bed using dipyridamole in the diagnosis of coronary insufficiency].

J Cerný, J Kandus, P Cerný

Vnitr Lek 1989, 35(9):913-920

The authors give an account of the mechanism of action of dipyridamole. Via adenosine it produces selective and maximal vasodilatation of resisting coronary vessels in the non-ischaemic area. Thus redistribution of the blood flow from the ischaemic to the non-ischaemic portion of the heart muscle occurs along with clinical and electrocardiographic manifestations of cardiac angina which can be used for its diagnosis. The pharmacological dipyridamole test makes detection of myocardial ischaemia possible in a fundamentally different way as compared with other loading tests. The authors mention pharmacodynamic, metabolic, haemodynamic and associated phenomena...

[The peroral dipyridamole test in the diagnosis of coronary insufficiency].

E Miklová, J Simícek, P Stverák, D Michalík

Vnitr Lek 1989, 35(9):921-923

Sixty-six subjects selected at random during the routine work of a medical outpatient department, without typical cardiac complaints, aged 58.4 +/- 8.2 years, and 29 patients in the third week after a new myocardial infarction aged 55.8 +/- 6.9 years drank on fasting a suspension of 450 mg dipyridamole. The ECG tracing was made on fasting, 45 and 60 minutes after ingestion of the suspension, on development of angina pectoris immediately and then aminophylline was administered by the i.v. route. In the first group there were 4.5%, in the second group 24.1% positive tests of coronary insufficiency. The oral test replaces the intravenous dipyridamole...

[Idiopathic unilateral chylothorax].

F Lakatos, J Vrastyak

Vnitr Lek 1989, 35(9):924-928

A 40-year-old female patient developed spontaneous right-sided chylothorax which after a single thoracocentesis did not relapse. Available examination methods did not reveal the cause of the disease. From the clinical course it may be assumed that the chyle drainage was impaired in the thoracic duct or in a minor lymphatic vessel by subclinical injury, whereby the damage obviously was small, capable of spontaneous closure and healing. The authors present some contemporary views on the pathogenesis, diagnosis and treatment of this rare disease.

[The peroral dipyridamole test in the diagnosis of coronary insufficiency].

J Cerný

Vnitr Lek 1989, 35(9):930-932