[25 years' experience with diagnosis of pheochromocytoma].

I Balazovjech

Vnitr Lek 1995, 41(8):513-516

The author submits his 25-year experience with the diagnosis of pheochromocytoma in 36 patients. He evaluates the clinical picture by discrimination analysis of subjective symptoms and objective signs of the disease. Hypertension--by 24-hour monitoring of the blood pressure. In case of slight elevation of catecholamines he uses the Estulice test. In liminal cases patients are dispensarised. Due to a higher frequency of CT examinations in hypertonic patients findings of adenomas of the adrenals cumulate which are hormonally inactive. Gammagraphy can in that case confirm a functionally active pheochromocytoma, it can however produce also a falsely positive...

[Diagnostic sensitivity of 24-hour electrocardiographic Holter monitoring in indications for coronarography].

R Rybár, G Valocík, S Juhás, D Pella, D Trejbal, M Pjescák, D Soroková

Vnitr Lek 1995, 41(8):518-521

The authors evaluated 24-hour ECG monitoring (Holter monitoring) in 70 patients indicated for coronarography. They assessed the sensitivity, specificity, positive and negative predictive value of Holter monitoring. They compared the findings with data reported in the literature and with the sensitivity of the ergometric test for indication of patients for coronarographic examination. Although the sensitivity and specificity of Holter monitoring does not exceed generally reported values of sensitivity and specificity of bicycle ergometry, in the discussion the authors mention conditions where Holter monitoring is an asset for indication of patients...

[Hepatitis C virus antibodies in hemodialyzed patients].

L Korcáková

Vnitr Lek 1995, 41(8):522-524

Assessment of antibodies against the hepatitis C virus (HCV) in 629 patients treated by haemodialysis in 47 dialyzation centres revealed the probability of HCV infection in 196 of them, i.e. in 31%. In a group of 91 patients newly admitted for dialysis, antibodies against HCV were found in 24, i.e. in 26%. The percentage of anti-HCV antibody carriers in different dialyzation units varied between 6 nad 60.

[A relapsing and protracted form of viral hepatitis A: comparison of adults and children].

J Stránský, E Honzáková, J Vandasová, J Kyncl

Vnitr Lek 1995, 41(8):525-530

In recent years in children and adults with acute viral hepatitis A relapses and a protracted course of the disease were described. The authors followed up 37 patients with viral hepatitis A (20 children and 17 adults) and compared the clinical course of the disease, the period of hospitalization, persistence of IgM anti-HAV antibody in serum, the incidence of relapses and protracted forms of the disease. In adults the mean hospitalization period was longer (28 days as compared with 19), the average serum bilirubin value was higher (94 mumol/l as compared with 51 mumol/l), there were more cases with obvious jaundice (59% as compared with 30%) and the...

[New aspects of pharmacologic and general prophylactic care of the diabetic foot].

E Záhumenský, J Rybka, A Adamíková

Vnitr Lek 1995, 41(8):531-534

Ischaemia, neuropathies and infections are predisposing factors for the development of ulceration of the diabetic foot. Diabetics have evidently a disposition for affections of the peripheral circulation and impaired regulation of the microcirculation as a result of autonomic neuropathy. The lower the driving pressure (in critical ischaemia), the more important are rheological factors and drugs which can influence them. These preparations include e.g. Trental (pentoxiphilline), Prostavasin (prostaglandin E1), Vessel due F (sulodexide). In advanced stages of ischaemic extremities oedema is a very adverse factor. Non-cardiac oedema can be very effectively...

[A vasoactive-intestinal-polypeptide producing tumor (VIPoma) as an uncommon cause of life-threatening hypokalemia].

L Mráz, Z Rusavý, P Zdeněk, M Heidenreichová, J Kozeluhová, J Steinigerová, P Těsínský

Vnitr Lek 1995, 41(8):535-537

The authors present a case of a 40-year-old female patient examined repeatedly in the course of 11 years and hospitalized on account of pain in the hypogastrium, subfebrile temperatures, watery diarrhoea, hypokaliaemic alkalosis, weakness, fatigue and loss of body weight. As to laboratory examinations hypokaliaemia, hyponatraemia, metabolic alkalosis, irregularly elevated CRP values and minor leucocytosis predominated. A weight loss of cca 8 kg along with a severe mineral deficiency and clinical symptomatology called for parenteral nutrition with a mean daily substitution of 240 mmol K and 200 mmol Na. Due to the clinical condition and non-specific...

[Functional activity of a metastatic differentiated carcinoma of the thyroid gland].

O Kraft

Vnitr Lek 1995, 41(8):538-540

In a patient with differentiated thyroid carcinoma of the follicular type after removal of the thyroid gland and nodular secondaries on the neck a functional secondary was detected in the liver by combined whole-body scintigraphy following administration of 131-I and scintigraphy of the liver using 99mTc-colloid, supplemented by scintigraphy of the skeleton following administration of 99mTc-MDP. At first the high thyroglobulin serum level was after repeated radioiodine treatment falsely negative. The author presents a review of cases reported in the literature who suffered from this rare type of secondaries.

[Arrhythmogenic right ventricle].

J Kajzr, J Bastecký, J Kvasnicka, L Steinhart, V Rozsíval, I Gajdosová, M Pleskot

Vnitr Lek 1995, 41(8):541-544

A 26-year-old patient with an irrelevant personal and family-history was treated on account of attacks of relapsing ventricular tachycardia and cardiac failure, mostly dextrolateral. After ruling out other possible causes of the disease--such as embolism of the lungs, ischaemic heart disease, out other possible causes of the disease--such as embolism of the lungs, ischaemic heart disease, Ebstein's anomaly, the diagnosis of an arrhythmogenic right ventricle was established. This disease is suggested by negative T waves in the thoracic leads V1-V3 during sinus rhythm and by the shape of the QRS complex which was the type found in block of the Tawara...

[Determination of serum lactic acid and the acid-base equilibrium in carbon monoxide poisoning].

K Kubát, M Zboril

Vnitr Lek 1995, 41(8):545-548

The authors present a description of severe accidental carbon monoxide poisoning. They stress the significance of the examination of lactic acid level at this poisoning. In case described the level of carbonyl haemoglobin could not be determined because of device trouble. Patient AA (16-year-old) was admitted in relatively very good condition, without clinical signs of severer affection. Considering the facts that gas-poisoning (over 24 hrs) was found through anamnesis, and simultaneous admission of patient's greatgrandmother in critical condition, the patient AA was treated also with oxygen of high concentration, monitored, kept in absolute rest....

[Proton pump blockers and their significance in gastroenterology].

P Dítě, J Prásek

Vnitr Lek 1995, 41(8):549-554

Extremely effective drugs used in the therapy of diseases etiologically associated with excessive HCl secretion by the gastric mucosa include proton pump blockers. Their obvious advantage, as compared with commonly used drugs, is that they cause a marked drop of HCl production by the gastric mucosa regardless of the type of stimulus, i.e. whether parietal cell receptors are influenced. Their therapeutic action is extremely effective, while side-effects are minimal. The publication gives the basic indications of administration of proton pump blockers, compares their therapeutic efficiency with H2 blockers and draws attention to possible pitfalls of therapy.

[Regulation of HDL lipoprotein plasma levels in relation to atherogenesis].

V Růzek

Vnitr Lek 1995, 41(8):555-559

There is no doubt nowadays on the importance of HDL lipoproteins in atherogenesis. In the submitted review the author presents information on the regulation of HDL lipoprotein plasma levels and their sub-classes. First he deals with metabolic relations, in particular synthesis and catabolism of HDL lipoproteins. He mentions then factors which influence plasma levels of HDL lipoproteins and their sub-classes--external and internal factors. As to internal factors the author discusses genetic predisposition, sex, age, obesity, adipose tissue distribution; as to external factors the effect of diet, exercise, alcohol, smoking and drugs.

[Angiotensin converting enzyme inhibitors in the treatment of arterial hypertension].

J Widimský

Vnitr Lek 1995, 41(8):560-564

The author presents a brief account on mechanisms of action of ACEI in arterial hypertension. He mentions different representatives of ACEI, incl. new pharmacological preparations. He mentions the basic strategy of treatment, incl. clinical indications of the use of ACEI in hypertension and suitable and less suitable combinations of drugs. In the conclusion he mentions the most frequent side-effects of ACEI, absolute and relative contraindications of ACEI.

[The molecular basis and in vitro determination of multiple resistance to cytostatic agents].

J Krejsek, O Kopecký

Vnitr Lek 1995, 41(8):565-568

Contemporary therapeutic procedures used in the treatment of malignant diseases are based on the no-selective action of cytotoxic or cytostatic substances. The sensitivity of tumour cells to cytostatics can be, however, reduced by the action of several mechanisms among which expression of the membrane glycoprotein P-170 is the most important. The latter actively transfers the cytotoxic substance from the cell and is responsible for multiple drug resistance-MDR). Glycoprotein P-170 can be assessed on leukaemic cells immunochemically by flow cytometry. A very perspective procedure is assessment of the in vitro sensitivity of leukaemic cells to clinically...

[Sigismundus Albicus, the first rheumatologist at Charles University in Prague (1358-1427)].

M Vykydal

Vnitr Lek 1995, 41(8):569-570