[Postoperative atrioventricular and intraventricular block in tetralogy of Fallot. Electrophysiology study].

B Vítek, A Necasová, J Procházka, M Suchánek, I Jíra

Vnitr Lek 1989, 35(11):1041-1048

One of the causes of the late deaths after operations of the tetralogy of Fallot are dysrhythmias caused by impaired conduction and automatism. To assess the severity and site of the atrioventricular and intraventricular block the authors used in 19 patients after operation of the tetralogy of Fallot an invasive electrophysiological examination. The authors recommend, based on their own experience, to follow-up on a long-term basis all patients with temporary postoperative complete a-v block. The presence of bifascicular or temporary postoperative a-v block alone does not yet imply the need of a permanent pacemaker. If a serious a-v block persists...

[The effect of procainamide on the inducibility of ventricular tachycardia using programmed stimulation].

J Lukl, P Heinc, B Cernosek

Vnitr Lek 1989, 35(11):1049-1056

The effect of intravenously administered procainamide (0.5-1 g, mean 0.966 g) on the inducibility of sustained ventricular tachycardia by programmed ventricular stimulation was tested in 15 patients (12 men and 3 women, mean age 57.2 +/- 16.6 years) with confirmed sustained ventricular tachycardia. Eleven patients had a previous myocardial infarction and two had congestive heart failure. The programmed ventricular stimulation (1-3 premature stimuli following after ventricular stimulation at a rate of 100/120 and 140/min. and a number of quick stimuli with a rising frequency from the apex of the right ventricle at an intensity equal to twice the diastolic...

[2-dimensional echocardiography of mitral stenosis in patients 60 years of age and older].

S Juhás, J Mechír, V Mechírová

Vnitr Lek 1989, 35(11):1057-1061

The authors examined 28 patients with mitral stenosis aged 60 years or older, incl. 20 (71%) with atrial fibrillation and 14 (50%) who had moreover signs of heart failure. None of them suffered from severe mitral stenosis with an area of the mitral orifice smaller than 1 sq. cm. Statistical comparison of groups of patients with sinus rhythm and atrial fibrillation and groups with symptoms of heart failure or without it revealed a significant difference only between the areas of the mitral orifice (P less than 0.005). In the other echocardiographic indicators (dimensions of the left atrium and volume ratio of its evacuation, left ventricular ejection...

[Comparison of the effects of diltiazem and isradipine in patients with chronic stable angina pectoris].

J Meluzín, Z Lupínek, M Novák, P Rotrekl

Vnitr Lek 1989, 35(11):1062-1071

In 21 patients with chronic stable angina pectoris stage II-III according to NYHA, by means of bicycle ergometry antianginous and antiischaemic effects of short-term dilthiazem administration (Blocalcin 60, Lachema) were compared with isradipine (Lomir, Sandoz). Dilthiazem was administered in three doses à 90 mg by mouth (midday, evening and subsequent morning), isradipine in a similar way but in three doses à 5 mg. Both preparations reduced, as compared with placebo, significantly the systolic and diastolic blood pressure at rest and the diastolic pressure during a load, dilthiazem also the systolic pressure during a load. Both drugs...

[Left ventricular systolic function during exertion in persons with mild and medium levels of hypertension].

H Vizinová, M Myslivecek, I Oral, A Hyzák

Vnitr Lek 1989, 35(11):1072-1078

In a group of 34 men aged 30-59 years with essential hypertension of a mild or moderate degree the authors evaluated the behavior of the left ventricular ejection fraction and the rate of shortening of the circumferential fibre, using radionuclide ventriculography during exercise. The results were compared with a control group of 19 subjects lacking signs of cardiovascular disease. Asymptomatic hypertonic patients without signs complicating IHD have on average a small statistically insignificant reduction of values of the ejection fraction at rest and of the shortening of the circumferential fibre. However, they respond to a load by a significantly...

[Vascular changes in essential hypertension after treatment with enalapril].

J Dusek, J Siegelová, P Prikryl, V Kunovská, P Mayer

Vnitr Lek 1989, 35(11):1079-1086

A group of patients with essential hypertension and healthy subjects from the same work place were investigated for a period of four weeks and were subjected, in addition to a basic clinical medical examination, to an ergometric examination ECHO cardiography, occlusion plethysmography, and concurrently serum levels of adrenaline (A), noradrenaline (NA), renin, cyclic adenosine monophosphate (cAMP) beta receptors before and after four weeks treatment with enalapril were assessed. The results are consistent with available data from the literature where administration of inhibitors of the angiotensin converting enzyme (ACE) caused a reduction of the peripheral...

[Relation between echocardiographic indicators and beta 2-adrenergic receptors in essential hypertension during treatment with enalapril].

M Precechtělová, J Siegelová, V Kunovská, P Prikryl, P Svoboda, J Dusek, A Záková

Vnitr Lek 1989, 35(11):1087-1093

A group of 22 men with essential hypertension stage I and II according to WHO, mean age 29.1 +/- 1.4 years, was divided at random into two sub-groups. Eleven patients were treated for four weeks with enalapril (E), 10 mg/day, 11 patients were given placebo (P), also for a period of four weeks. The patients were subjected to echocardiographic examination before and after four-week therapy with enalapril or placebo. In patients treated with E a significant reduction of the left ventricular wall and the interventricular septum was observed. There was also a highly significant decline of the weight of the left ventricle and the index of left ventricular...

[Energy support with parenteral nutrition in patients with chronic intestinal inflammation].

J Kábrt, P Fric, Z Masek, V Pacovský, S Svacina

Vnitr Lek 1989, 35(11):1094-1101

Parenteral nutrition (PN) was administered to 24 patients with chronic enteritis. Their mean age was 37 years (range 17 to 69 years). Seventeen times Crohn's disease was involved, five times ulcerative colitis and twice postprandial enteritis. The mean period of PN was 24.6 +/- 12.9 days and its energy value was 7.79 +/- 1.63 MJ/24 hours. Some patients had a restricted oral intake, on average 5 MJ/24 hours. The energy output at rest assessed by indirect calorimetry was 7.62 +/- 1.06 MJ/24 hours. Along with PN the patients had aimed antiinflammatory treatment. In the majority of patients clinical improvement was recorded. The nutritional status improved...

[Relation of the effect of human complement in the cytotoxic test to the origin of the HLA serum].

A Májský

Vnitr Lek 1989, 35(11):1102-1105

The use of human complement in HLA typing produced strongly positive results only in examinations with polyspecific sera from pregnant women, while with mono- or bispecific sera positive results were obtained only in some instances and the results were usually weaker. With polyspecific sera from patients after multiple transfusions negative results were obtained. The action of complement did not depend on the titre of HLA cytotoxins. The results confirm the hitherto held view that it is not suitable to use human complement for HLA typing.

[Locally produced monoclonal antibodies for the diagnosis of acute leukemias].

V Koza, P Cetkovský

Vnitr Lek 1989, 35(11):1106-1110

In 35 cases of acute leukaemia in addition to the basic morphological and cytochemical examination immunophenotyping with locally produced monoclonal antibodies from the Institute of Molecular Genetics, Czechoslovak Academy of Sciences, Prague, was made. In 33 instances it proved possible to differentiate the leukaemic cells, two leukaemias were described as non-differentiated. Local antibodies MEM 78, MEM 75, MEM 57, MEM 32, MEM 31, MEM 18 and HL-40 can be considered basic monoclonal antibodies for the diagnosis of acute leukaemia.

[Diabetic ketoacidosis and hyperglycemic hyperosmolar nonacidotic syndrome in type I and II diabetics].

J Kmoch, J Kmoch

Vnitr Lek 1989, 35(11):1111-1119

The author analyzes 46 hyperglycaemic comatose conditions in diabetics treated at the medical clinic of the Paediatric Faculty, Charles University Prague in 1978-1985. In the group older patients with type II diabetes predominated, where acute decompensation was frequently of the hyperosmolar type without acidosis and it was usually associated with a higher mortality. The cause of the metabolic breakdown was most frequently infection, in type II diabetes, however, an equally important part was played by acute cardiovascular disease. Insulin was administered in small doses by the i.v. route either as a continuous infusion or in fractionated doses. The...

[Treatment of diabetic neuropathy].

E Ehler

Vnitr Lek 1989, 35(11):1120-1124

The author presents in his review information on contemporary possibilities in the treatment of diabetic neuropathy. This treatment is focused on strict compensation of diabetes, on support of the metabolism in the peripheral nerves and on symptomatic relief of the patient's complaints. Treatment of diabetic autonomic neuropathy which is so far only symptomatic, still remains a problem.

[Is absorption hemoperfusion effective in the treatment of baclofen poisoning?].

V Monhart, M Balíková

Vnitr Lek 1989, 35(11):1125-1131

By six-hour sorption haemoperfusion over active charcoal in a 33-year-old woman intoxicated with baclofen (Baclofen Polfa) the initial plasma concentration was reduced by 87%, while from the blood only 3% of the ingested dose were removed. Therefore the capacity of baclofen elimination was tested by perfusion and dialysis in vitro. Two-hour dialysis with the Czechoslovak haemodialyzer Chiraplat was equally effective for removal of baclofen from an aqueous solution (21.2 mg) as four-hour perfusion over active charcoal and resin--Czechoslovak haemoperfusion columns Hemasorb 800 C (19.4 mg) and Hemasorb 800 A-4 (18.9 mg). Because during the first 30 minutes...

[Polymyalgia rheumatica, Takayasu's disease and the aortic arch syndrome].

J Vachteheim, M Vilímová

Vnitr Lek 1989, 35(11):1132-1136

The authors discuss the causes of the aortal arch syndrome in a 65-year-old female patient, whom they observed in conjunction with rheumatic polymyalgia probably associated with Takayasu's disease. During corticoid treatment subjective as well as objective symptoms receded. When the doses were reduced, the original clinical symptoms and laboratory findings reappeared. It is probable that this course escapes attention and is ascribed to other diagnosis. If more attention will be paid to the aortal arch syndrome, it will be possible to diagnose it more often.

[Medicine in the life and work of Zikmund Winter].

J Kohout

Vnitr Lek 1989, 35(11):1137-1140