Vnitřní lékařství, 1996 (vol. 42), issue 8
[Trends in indications for permanent cardiac pacing therapy at the Cardiac Pacing Center in Eastern Slovakia 1978-1994].
B Stancák, J Bodnár, J Pella, M Palinský, S Misíková, E Komanová, J Sedlák
Vnitr Lek 1996, 42(8):513-518
At the Third Medical Clinic, which acts as a cardiostimulation centre for the eastern Slovak area, in 1978 to 1994 1 581 primary implantations and 996 reimplantations of pacemakers were made. In the group of primary implantations the mean age of patients was 70.7 +/- 10.9 years, the male/female ratio was 850/731. In the group of reimplantations the mean age was 71.3 +/- 11.6 years, incl. 483 men and 513 women. There is an almost linear rise of primoimplantations. In the group of reimplantations we can observe a two-peak shape of the curve with a maximum in 1986 and in 1990. While in 1978 atrioventricular block grade III accounted for almost 90% indications...
[Changes in troponin T levels in patients with acute myocardial infarct treated with fibrinolysis].
J Bastecký, V Palicka, J Vávrová, E Ettlerová, V Wasyliwová
Vnitr Lek 1996, 42(8):519-523
The objective of the presentation was to assess changes of the troponin T level--a very sensitive indicator of cardiac muscle damage--in patients with acute myocardial infarction treated by fibrinolysis, and to assess differences in troponin T levels between patients with successful reperfusion and without reperfusion. The troponin T level was examined in 28 patients with acute myocardial infarction (AIM), incl. 22 (78.6%) where probably reperfusion occurred, as concluded from a maximal increase of CPK and CPK MB values within 12 hours. In six patients with a later rise of enzyme values treatment was considered as probably unsuccessful. In both groups...
[Causes of failure in surgical treatment of acute dissection of the ascending aorta (type A)].
J Hejnal, J Pirk, P Pavel, A Mokrácek
Vnitr Lek 1996, 42(8):524-527
In 27 patients with acute dissection of the ascending aorta where during 1988-1995 for reconstruction of the affected portion of the aorta an intraluminal prosthesis was used, a retrospective analysis of some factors was made to evaluate their importance for the final result of the operation. The analysis proved the fundamental importance of complications present before operation. Among them, in association with the extent of the dissection, the most important one proved to be cardiac tamponade, impaired renal function and a state of shock. More detailed analysis revealed the unequivocal relationship of the development of these complications with the...
[Importance of dipyridamole transesophageal echocardiography in the diagnosis of ischemic heart disease].
J Spác, H Nĕmcová, O Hlinomaz, M Blaha, I Dvorák
Vnitr Lek 1996, 42(8):528-532
The importance of dipyridamol echocardiography in the diagnosis of ischaemic heart disease (IHD) was described repeatedly. Nevertheless in roughly 20% patients the transthoracic echocardiographic examination at rest is inaccurate or cannot be carried out because the ultrasonic visibility is poor. In these patients transoesophageal dipyridamol echocardiography (TEE Dip) can provide a suitable alternative. This is why the authors evaluated 36 patients examined on account of IHD before and after administration of 0.80 mg/kg dipyridamol. The left ventricle was visualized in the transgastric short axis and from the apical view. Angiography revealed significant...
[Fluvastatin in the treatment of hyperlipoproteinemia, initial experience].
R Ceska
Vnitr Lek 1996, 42(8):533-536
BACKGROUND: HMG CoA (beta-hydroxy-beta-methylglutaryl coenzyme A) reductase inhibitors are very effective in lowering total and low-density lipoprotein cholesterol. Since the introduction of lovastatin for clinical use in the United States in 1987, statins have become widely available and the number of patients treated with these compounds is estimated to be over 2 million. The incidence of adverse effects is very low with elevated transaminase levels and myopathy being of greatest concern. Currently, several intervention trials demonstrated the influence of HMG CoA reductase inhibitors on total and cardiovascular morbidity and mortality and on regression...
[Determination of free radical activity in workers at risk for styrene exposure].
J Kohout, V Holecek, V Machartová, J Racek, Z Jerábek, V Senft
Vnitr Lek 1996, 42(8):537-539
The authors examined indicators of the effect of free radicals (MDA, SOD, GSHPx, selenium) in 38 workers exposed to styrene. They revealed a statistically significant (p < 0.01) correlation of SOD activity and the period of exposure to styrene and also a statistically significant correlation (p < 0.05) between urinary selenium excretion and the period of exposure to styrene as well as a statistically significant correlation (p < 0.01) between the MDA serum concentration and urinary selenium excretion. There is no statistically significant difference between the MDA plasma concentration among smokers and non-smokers, the SOD activity is significantly...
[Erythropoietin and erythropoiesis after kidney transplantation].
J Zadrazil, P Bachleda, T Grosmanová, J Zahálková, H Fingerová, P Petrová, D Novotný
Vnitr Lek 1996, 42(8):540-544
In a group of 15 patients after the first transplantation of a cadaverous kidney the authors monitored for the period of one month the serum erythropoietin concentration (Epo), haemoglobin levels (Hb), the haematocrit (Ht) and serum creatinine (Cr). The objective of the investigation was to evaluate in relation to serum concentrations of Epo and the function of the graft. Erythropoietin was examined by the authors own method before and after transplantation during the first 10 days daily and then on the 12th, 15th, 20th, 25th and 30th day. Normal values are 22-44 mU/ml. The mean Epo value before transplantation was 41.9 +/- 18.8 mU/ml. After transplantation...
[Determination of the bromodeoxyuridine index in multiple myeloma. II. Relation to level of advancement and disease activity].
V Scudla, M Ordeltová, J Bacovský, A Spidlová, V Vavrdová, D Sedlár
Vnitr Lek 1996, 42(8):545-550
In a group of 70 subjects with multiple myeloma (MM) formed by 25 patients examined before establishment of the diagnosis and 45 patients evaluated in different developmental stages of the disease, the authors evaluated the relationship between the value of the bromodeoxyuridine "labelling index" (BrdUrd-LI) and the clinical activity, stage and course of the disease. The authors revealed statistically significantly higher values of BrdUrd-LI in the group of patients in the "active" phase of the disease than in the "stable-plateau" phase of the disease. This applies also to findings within different clinical stages of the disease. The authors did not...
[Cathepsin B-like substance in the monitoring of chemically induced primary cholangiocarcinoma in swine].
V Dufek, J Petrtýl, P Klener
Vnitr Lek 1996, 42(8):551-554
Activity of beta-glucuronidase (GL), placentar izoenzyme of alkaline phosphatase (PLAP), cathepsin B (CB) and concentrations of carcinoembryonic antigen (CEA) were determined in serums and bile of pigs with experimental cholangiocarcinoma and in control animals. No differences in serum GL, PLAP, CB activities or CEA were observed. The same was found in bile for GL, PLAP and CEA. However, in bile the situation was different for CB. In all the tumour bearing animals we were able to demonstrate in the course of tumour development a stricking progression in CB activity. Very impressive was namely an elevation of CB alkaline-stable form, generated (according...
[Hemothorax in the posterior mediastinum in extramedullary hemopoiesis].
V Malinovská, V D'Andrea, P Dítě, L Malinovský, P F Baselice, R Bartolucci, E De Antoni
Vnitr Lek 1996, 42(8):555-556
The authors describe a rare case of spontaneous haemothorax in a 19-year-old woman suffering from beta-thalassaemia major which developed as a result of extramedullary haematopoiesis. In intrathoracic disorders of obscure origin they recommend therefore to make first a cytological examination of the punctate to prevent unnecessary surgery.
[Amylin as an additional possible pathogenic factor in NIDDM and the insulin resistance syndrome].
J Hrnciar
Vnitr Lek 1996, 42(8):557-560
The syndrome of insulin resistance comprises the following H-phenomena: 1. Hyperinsulinism compensating the inborn postreceptor insulin resistance, 2. Hyperglycaemia-non-insulin-dependent diabetes mellitus, 3. Hyperlipoproteinaemia with android obesity, 4. Hypertension, 5. Hirsutism with the syndrome of polycystic ovaries as a manifestation of a hyperandrogenic situation in the female organism. Molecular syndromes of this syndrome of insulin resistance are obscure. They are the subject of intensive studies because H-phenomena are an aggregation of the main risk factors of atherogenesis. Recently attention is focused also on amylin--a 37 amino acid...
[The role of echocardiography in patients with cerebrovascular stroke].
J Chlumský
Vnitr Lek 1996, 42(8):561-563
Echocardiography is along with computer tomography of the brain and sonography of the carotid arteries one of the basic examinations in patients with cerebrovascular attacks. Transthoracic echocardiography is performed in all patients with cerebrovascular attacks. Transoesophageal echocardiography is indicated in patients with atrial fibrillation, dilatation of the left atria, with an artificial valve or in young patients with an otherwise obscure cerebrovascular attack. The echocardiographic finding can decide in a fundamental way on the indication for anticoagulation treatment in these patients and thus reduce markedly the risk of a relapse of a...
[Changed views on vasoconstriction of coronary vessels and angina pectoris].
J Spácil
Vnitr Lek 1996, 42(8):564-567
Views on the impact spasms of the coronary arteries (in the work of distinguished internists and cardiologists) changed in recent years. At present it is obvious that even coronaries damaged by atherosclerosis (in particular eccentric stenoses) may react to vasoconstrictor stimuli by a spasm and this promotes various manifestations of ischaemic heart disease. The coronary arteries can respond by vasoconstriction to stimuli to which arteries without atherosclerotic changes react by vasodilatation. Hypolipidaemic treatment reduces not only stenoses of the coronaries but improves also their impaired vasomotorics. A spasm of a "sound" artery remains an...
[Treatment of hyperlipoproteinemia in clinical practice].
R Ceska
Vnitr Lek 1996, 42(8):568-572
There are sufficient arguments for treatment of hyperlipoproteinaemia at present and this treatment is considered not only rational but also an essential procedure in primary and in particular in secondary prevention of cardiovascular diseases. Views of scepticists as regards this treatment are, with regard to the most recent epidemiological studies with hypolipidaemic agents, not very convincing and the majority is refused. Treatment of patients with hyperlipoproteinaemia is comprehensive, its basis being dietary and lifestyle measures. The latter are, if they are not sufficiently effective, with increasing frequency supplemented with medicamentous...
[Treatment of chronic lymphatic leukemia].
Z Adam, J Vorlícek, N Hejlová
Vnitr Lek 1996, 42(8):573-578
Chronic lymphocytic leukemia (CLL) is a slow lymphoproliferative disease. The therapy has only a palliative effect and therefore the common attitude to the therapy is conservative (watch and wait policy). Monotherapy with alkylating cytostatics, usually chlorambucil, is considered by most authors to be the therapy of first choice. Only the French study showed superiority of polychemotherapy CHOP over monotherapy. New drugs for the treatment of chronic lymphocytic leukemia are purine-analogs. Fludarabine has been used mostly of this purine-analogs. The response rate to fludarabine therapy is 30-45% in pretreated patients and the response rate in the...