Vnitřní lékařství, 1996 (vol. 42), issue 9
[Why is it necessary to study the thyroid gland?].
V Schreiber
Vnitr Lek 1996, 42(9):589-591
Pathophysiological and clinical aspects of the thyroid gland include after many decades of intensive studies many yet unresolved problems. The relationship with the gastrointestinal system (iodine accumulation in the stomach and salivary glands), the function of thyroxine as a prohormone (in particular the regulation of the activity of tissues deiodinases, the action of triiodothyronine similar to that of steroid hormones, a mixture of protein anabolic and protein catabolic reactions to thyroid hormones, peculiar immune features of the thyroid gland (presence of immunogenic hyperfunctional and hypofunctional syndrome), sharing of common antigens by...
[History of the anatomy and surgery of the thyroid gland].
J Dvorák, J Leffler
Vnitr Lek 1996, 42(9):592-596
The submitted historically oriented paper reviews anatomical and surgical prerequisites for the development of thyroid surgery. Operations which up to the middle of the last century were associated with an extremely high lethality and were considered heroic and unjustified, changed due to new findings and procedures into standard operations performed in some thyroid diseases. Despite this, indications for operation and views on some surgical procedures are even in contemporary medicine highly controversial.
[The calcium tolerance test in thyrotoxicosis, Hashimoto's thyroiditis and after total thyroidectomy].
J Blahos, M Adam, H Hulejová, P Spacek
Vnitr Lek 1996, 42(9):597-601
Basic indicators of calcium and bone metabolism and the calcium tolerance test were investigated in patients with untreated hyperthyroidism, Hashimoto's thyroiditis, after total thyroidectomy and in controls. In florid hyperthyroidism elevated values of indicators of bone new formation (osteocalcin and bone fraction of alkaline phosphatases) and of bone resorption (urinary pyridinoline and deoxypyridinoline) were found and a protracted return of the serum calcium level to baseline values (during the 120th minute after completed infusion containing calcium). The calcitonin serum levels were significantly reduced after completion of the infusion up to...
[The effect of gender on prevalence and survival in thyroid carcinoma].
J Němec, P Chytrý, J Dvorák, P Vlcek, M Neradilová, P Racek, T Blazek, V Zeman
Vnitr Lek 1996, 42(9):602-604
Based on their own experience with a large group of patients with thyroid cancers, the authors confirm the higher prevalence of differentiated thyroid cancers both papillary and follicular (1 : 3,5) in females, while the differences in anaplastic and medullary cancers are much less prominent. Survival of females in univariate studies is much higher in both papillary and follicular cancers compared to males, in multivariate studies these differences lose their significance and only in papillary cancers under the age of 40 years at diagnosis and in a subgroup of papillofollicular cancers the differences retain their significance. The authors therefore...
[Thyroid gland function in women with breast carcinoma].
Z Límanová, J Barkmanová, Z Friedmannová, E Kasparová, E Tichá, I Spanlangová, A Jelínková
Vnitr Lek 1996, 42(9):605-609
Data in the literature concerning thyroid disease in women after treatment of breast cancer differ. The authors examined therefore the thyroid function (thyroid stimulating hormone, thyroxine, triiodothyronine, antibodies against thyroid peroxidase and against thyroglobulin) in a random sample of 76 women after ablation of the breast on account of carcinoma. A deviation in some of the investigated indicators was found in 46,7% of the examined women. A total of 10,5% women had an elevated level of thyroid stimulating hormone, in 18,4% both antibodies were positive, in another 11,8% antibodies against thyroglobulin only were positive and in 9,2% antibodies...
[Hormone suppression therapy in benign nodular goiter].
Z Málek
Vnitr Lek 1996, 42(9):610-614
Nodular goitre was detected in as many as 21 - 27% of the adult population in a non-endemic area. The most frequent therapeutic procedure is suppressive treatment with thyroxine. The author analyzes the results of prospective randomized, placebo controlled studies, which focused attention on the effectiveness of suppressive treatment. In the majority an inadequate effect was recorded. In the conclusion the author suggests an algorithm of suppressive treatment of nodular goitre and conditions after goitrectomy on account of nodular goitre.
[Organic chlorinated pollutants and the thyroid gland].
P Langer, M Tajtáková
Vnitr Lek 1996, 42(9):615-619
This review presents the definition of main groups of organic chlorinated pollutants (polychlorinated biphenyls, dibenzodioxines, dibenzofurans, hexachlorobenzene, hexachlorocyclohexane, DDT etc.). Moreover, the similarity of their effects with those of steroid and thyroid hormones either via steroid/thyroid receptor or via specific Ah-receptor is described. Special attention is paid to their effects on the thyroid gland in experimental conditions as well as on professionally and nonprofessionally exposed population. Finally, own preliminary data are presented which were obtained by the examination of 249 employees of the factory Chemko producing polychlorinated...
[Epitestosterone as an endogenous antiandrogen in men].
L Stárka, M Hill, O Lapcík, R Hampl
Vnitr Lek 1996, 42(9):620-623
The authors assessed in the plasma of 156 boys and men aged 6 - 65 years and in prostatic tissues of 15 men aged 55 - 82 years epitestosterone, C19-steroid with anti-androgenic properties. It was revealed that during the prepubertal period the epitestosterone level is higher than that of testosterone, in adult age the epitestosterone is about ten times lower than the testosterone concentration. In tissue of hyperplastic prostates the epitestosterone level is comparable with the androstendione level; it is about twice as high as the testosterone level and approximately half as high as the dihydrotestosterone level. Thus at least during the prepubertal...
[Endocrinopathy in the differential diagnosis of chronic fatigue syndrome].
I Sterzl, V Zamrazil
Vnitr Lek 1996, 42(9):624-626
Fatigue is a frequent and sometimes dominant symptom of some endocrinopathies. It may be associated with other symptoms which are included among the criteria of the chronic fatigue syndrome. These units are not always quite distinct and frequently endocrine diseases and chronic fatigue syndrome (CFS) overlap. From this ensue differential diagnostic problems and ideas on possible causal relations. The authors concentrate in articular on autoimmune endocrinopathies and the polyglandular autoimmune syndrome (APS) with emphasis on the necessity of an accurate endocrinological diagnosis, where is some patients with suspected CFS a defined endocrinopathy...
[Laboratory monitoring of therapy in Addison's disease].
A Kreze, E Kreze-Spirová, Z Putz
Vnitr Lek 1996, 42(9):627-631
UNLABELLED: Views on the usefulness of monitoring of substitution therapy in Addison's disease by hormonal laboratory indicators are controversial. The authors analysed the problem therefore in a group of 20 of their own patients. It was revealed that the adequacy of substitution of the cortisol deficiency can be very readily evaluated by diurnal profiles of cortisolaemia. The values of plasma ACTH provided less information, but were not unreliable. Assessment of free urinary cortisol did not prove useful. The adequacy of substitution of aldosterone deficiency reflected sensitively the plasma renin activity.CONCLUSIONS: monitoring by hormonal indicators...
[Indications for only pancreatic transplantation in the treatment of diabetes].
V Bartos
Vnitr Lek 1996, 42(9):632-634
As the safety of simultaneous transplantation of the kidney and pancreas worldwide as well as in this country is increasing, transplantation of the pancreas only in the treatment of diabetes is becoming a more real issue. Reflections pro and con are even more important as transplantation of the pancreas is not a life saving operation. Limiting factors are nephrotoxicity of cyclosporin and the hitherto not negligible morbidity after transplantation. Problems of indication involve evaluation of co-existing diabetic nephropathy and the objective evaluation of causes of neuroglycopenia. Transplantation of the pancreas alone may be indicated in type 1 diabetics...
[Personal experience with the diagnosis of organic hyperinsulinism].
J Skrha, G Sindelka, H Matějovská, J Hilgertová, V Justová, J Páv
Vnitr Lek 1996, 42(9):635-639
The diagnosis of organic hyperinsulinism was established in 47 patients based on the typical clinical symptomatology supported by laboratory evidence of hypoglycaemia and raised serum insulin concentrations. For the diagnosis of the disease the test of controlled fasting is suited best. During this test and after its termination the blood sugar level (in mmol/l), serum insulin (in mU/l) and their ratio (insulin/blood sugar) are assessed. In all patients the test had to be discontinued because clinical manifestations of hypoglycaemia developed which are typical for organic hyperinsulinism. Other methods, incl, examination by means of an isoglycemic...
[Comparison of insulin loss in treatment of diabetics using the classical syringe or the insulin pen (Novopen II)].
B Krahulec, L Strbová, E Seböková, J Cárský, I Klimes
Vnitr Lek 1996, 42(9):640-645
The aim of the study was to investigate changes in insulin wastage when transferring patients from vial insulin to Actraphane HM Penfills and NovoPen II. Twenty four diabetic patients, were treated with Actraphane HM 40 IU/ml vial for 3 months, then transferred to Actraphane HM Penfill and NovoPen II for further 3 months. Wastage 1 (difference between insulin consumption and the total prescribed dose) was higher in vials than in Penfills (268.7 +/- 69.4 IU/3 months/patients vs. -7.6 +/- 30.2 IU/3 months/patient, p < 0.001 mean +/- SEM). Wastage 2 (insulin remaining in the container when discharged) was higher in the Penfills than in vials (214.1...
[Personal experience with the Mono type of insulin--clinical study].
J Kalivoda, J Perusicová
Vnitr Lek 1996, 42(9):646-648
A multicentric study was conducted in March to September 1995 to test the effectiveness and tolerance of a new insulin series. A total of 281 diabetics above 15 years of age were followed up, 144 men and 137 women, mean age 63 years with a duration of diabetes from 0.5 to 51 years, without serious organ complications and capable to recognise symptoms of hypoglycaemia. During the investigation a total of five examinations of the investigated parameters were made. The authors revealed a statistically insignificant decline of body weight, blood sugar level on fasting and HbA1c and a significant drop of the postprandial blood sugar level. The BP reading...
[Is the aldosterone-renin ratio useful in screening for primary aldosteronism?].
A Kreze, D Okálová, J Hrnclar
Vnitr Lek 1996, 42(9):649-651
Despite improving laboratory and imaging methods the diagnosis of primary aldosteronism still remains a problem. One of the reasons is inadequate sensitivity of classical screening of this secondary arterial hypertension by hypokalemia. In the submitted paper the authors review data from the literature on more sensitive screening by means of the aldosterone-renin ratio. Its inclusion among basic examinations in patients with arterial hypertension seems fully justified.