[Initial experience with transesophageal echocardiography].

J Novotný, J Fiserová

Vnitr Lek 1990, 36(2):105-112

The authors present their initial experience with a new echocardiographic method, transoesophageal echocardiography (TEE). From an oesophageal approach it gives a remarkable view of the anatomy and functional parameters of the heart in practically all examined patients. It opens also new diagnostic possibilities. The main advantages of the method include the possibility to use high frequency probes (5 MHz, or more), which visualize more subtile structures than transthoracic echocardiography (TEE). A valuable aspect is also the absence of interfering structures such as lungs and ribs.

[Clinical significance of intracardiac electrocardiography in the diagnosis of syncope].

V Chytil

Vnitr Lek 1990, 36(2):113-120

An important advance in the diagnosis of arrhythmias as the cause of syncopes is the introduction of intracardiac electrocardiography and diagnostic electric stimulation known at present as clinical cardiac electrophysiology. The author examined a group of 70 patients with syncopes and divided them into two sub-groups. The first group comprised 46 patients examined by means of a hisogram and assessment of the recovery period of the sinus node and the second group 24 patients where the examination comprised in addition programmed stimulation of the right atrium and ventricle. In the first group the examination explained the cause of syncopes in arrhythmia...

[Treatment of postinfarction ventricular tachycardia based on the results of programmed stimulation].

J Lukl, B Cernosek, P Heinc

Vnitr Lek 1990, 36(2):121-127

Serial testing of antiarrhythmic agents (group I and III or their combination) by means of programmed pacing using a simple protocol (1-3 premature stimuli during stimulation from the apex of the right ventricle at a rate of 100 [120] and 140/min) and milder criteria of the effectiveness of treatment (does not produce significant ventricular tachycardias of a frequency above 150/min and with a duration longer than 30 s) was performed in 21 patients with significant post-infarction ventricular tachycardia (same definition of significance). Effective treatment was found in serial testing in 17 patients, i.e. in 80%. According to the results of serial...

[The effect of VUFB diltiazem tablets on the sick sinus and on electrophysiologic parameters of the heart atrium].

A Mádle, J Kudová, J Vainer, J Smíd

Vnitr Lek 1990, 36(2):128-133

Using invasive electrophysiological methods, the authors evaluated the preparation Diltiazem VUFB tablets on parametres of sinus automaticity in the "sick sinus syndrome" and on properties of the atria. They confirmed significant inhibition of automaticity which is not signalized by a corresponding decrease of the nodal frequency, and may remain concealed and lead unexpectedly to disorders of the cardiac rhythm. This is not a specific property of the preparation, a similar action on the sick sinus is exerted by all calcium antagonists with clinically confirmed effects on the conduction system. Diltiazem is already produced in this country and sold...

[Comparison of the effects of depot isosorbide dinitrate (Isoket Retard 120) and diltiazem in patients with exertional angina pectoris].

J Meluzín, Z Lupínek, Z Lupínková

Vnitr Lek 1990, 36(2):134-140

In a simple blind crossover 7-week study with a randomized beginning the authors compared in 13 patients with stable angina pectoris after exercise the action of diltiazem (Blocalcin 60, Lachema) and isosorbidedi nitrate (Isoket retard 120, Schwarz). Both drugs improved significantly, as compared with placebo, the tolerance of the load, reduced the frequency of stenocardias per 24 hours, diltiazem also the nitroglycerin consumption per 24 hours. Diltiazem reduced significantly, as compared with isosorbidedi nitrate, the pulse rate at rest, it reduced significantly Robinson's index and the diastolic pressure at rest. In none of the other investigated...

[Manifestations of dysfunction of the proximal tubules after intravenous urography].

L Haragsim, K Hátle, P Stolba, J Nedvídková, K Němecek, V Knotková, J Sekava

Vnitr Lek 1990, 36(2):141-146

The aim of the work was to investigate functional changes of tubular cells after i.v. urography. As evidence the authors used assessment of urinary levels of membrane-bound enzymes--alkaline phosphatase (AP), gamma-glutamyl-transpeptidase, lysosomally bound enzymes N-acetyl-beta-D-glucosaminidase and its isoenzyme B and the low molecular protein, beta-2-microglobulin. The above substance were assessed in 15 patients with different nephropathies where i.v. urography was indicated. The examinations were made in 24-hour urine samples before i.v. urography and in two 24-hour samples after administration of the contrast substance. In all patients a significant...

[Variations in indicators of humoral immunity in type I diabetes].

I Hulinský, M Dryáková, J Kaslík, J Malý

Vnitr Lek 1990, 36(2):147-153

The authors examined 21 patients with type I diabetes within 30 days after establishment of the diagnosis and during the first year of the disease. In 17 they detected autoantibodies against insulin at the time of assessment of the diagnosis before administration of the therapeutic insulin preparation. Fourteen patients had antibodies against the surface of islet cells (ICSA), the titre of which declined during the first year of the disease. The serum immunoglobulin level (IgG, IgM and IgA) was on average within the normal range; however, in two patients at the time of establishment of the diagnosis and in three patients after one month IgG was above...

[The effect of elevated blood glucose levels and body weight on the metabolic profile in type 2 diabetes after long-term therapy].

J Válek, Z Vlasáková, J Pelikánová, I Karasová, A Jirkovská, D Grafnetter

Vnitr Lek 1990, 36(2):154-162

Based on an analysis of data obtained in a group of 145 men and women with type 2 diabetes perssiting for 10.1 +/- 6.6 years who were hospitalized on account of unsatisfactory compensation of diabetes, the authors provided evidence that the fasting blood sugar level is associated with a reduced response of C peptide to an alimentary stimulus, while the excessive weight of the patients has a bearing on the elevated concentration of C peptide on fasting and causes their insulin resistance. The body weight has a bearing on the level of risk factors, i.e. HDL cholesterol, uric acid and in women also triacylglycerols. The elevated blood sugar level influences...

[Changes in fibrinolysis in diabetes mellitus].

E Tóthová, J Mechír, I Suchmanová, B Mudronová

Vnitr Lek 1990, 36(2):163-169

The authors examined in a group of 165 diabetics and 50 healthy subjects the basal fibrinolytic activity after venostasis and in a selected group of diabetics also after stimulation with adiuretin. They revealed not only a retarded fibrinolytic activity in diabetics with angiopathy, as compared with healthy subjects, but also a significant deterioration of the response in this group to stimuli such as venostasis and adiuretin. The authors draw attention to the fact that changes of the fibrinolytic activity which were more marked in diabetics with angiopathy may be conditioned not only by age, the duration of the disease and the elevated inhibitors...

[Campylobacter pylori, its detection and association with common pathologic conditions of the gastro-duodenum].

B Fixa, O Komárková, J Krejsek, J Bures, B Melichar, I Dvorácek

Vnitr Lek 1990, 36(2):170-176

The authors evaluate clinical experience based on a correlation between the clinical condition and the finding of Campylobacter pylori (CP) in a total of 1027 specimens of the gastric mucosa. They confirmed the high incidence of CP in patients with a fresh duodenal ulcer (g 7%) but also in the inactive stage of duodenal ulcer disease (97.8%) and in patients with a pyloric ulcer (94.4%). An analogous incidence of CP in patients with so-called isolated duodenitis (in the course of the disease no ulcer lesion was ever detected), i.e. in 95.5%, indicates the relationship of this condition with peptic ulcer disease. The authors indicate diagnostic possibilities...

[Ischemic colitis as a localized manifestation of ergotism?].

M Sorf, V Krislo, M Gogora

Vnitr Lek 1990, 36(2):177-179

The authors discuss a case of the development of ischaemic colitis in a 69-year-old female patient with superficial thrombophlebitis of the lower extremity treated by a combination of dehydrated ergot alkaloid Secatoxin forte drops with smaller doses of Heparin inj. After ruling out other causes of the development of ischaemia, the authors consider ischaemic colitis a local manifestation of ergotism.

[Lithogenesis from the aspect of biliary acid metabolism].

A Trencanský, V Baláz

Vnitr Lek 1990, 36(2):180-185

[Preoperative preparation of patients with arterial hypertension from the viewpoint of the internist].

I Tokárcik, A Tokárciková

Vnitr Lek 1990, 36(2):186-193

In their review the authors submit pathophysiological comments on arterial hypertension in conjunction with general anaesthesia and they evaluate the risk of anaesthesia in hypertensive subjects. They discuss in more detail the preoperative preparation of the above patients by presenting actual data on the interactions of general anaesthetics with diuretics, beta-blockers, blockers of calcium channels and other antihypertensive preparations. Their own experience pertains to the preoperative administration of selected diuretics, used in this country, i.e. Trimepranol and Corinfar.