Vnitřní lékařství, 1989 (vol. 35), issue 2

[The effect of sodium levels in dialysis solutions on the distribution of total body water during hemodialysis].

M Mydlík, K Derzsiová, J Svec, P Mizla, M Takác

Vnitr Lek 1989, 35(2):105-111

Thirty-seven haemodialyses with ultrafiltration were performed (3000 ml/6 hours). using three sodium concentrations (140, 145 and 150 mmol/l) in the dialysate solution in 16 hyperhydrated patients during a long-term dialysis program. The amount of eliminated sodium during haemodialysis depended on the sodium concentration in the dialysate solution. The reduction of the volume of total body water corresponded to ultrafiltration. When a sodium concentration of 150 mmol/l in the dialysate solution was used, the smallest diminution of extracellular fluid and greatest diminution of intracellular fluid was observed. At the same time the greatest transport...

[Comparison of the degree of chronic gastritis in the resected gastric body with histologic findings in postoperative gastric biopsy].

J Hájek, I Steiner

Vnitr Lek 1989, 35(2):112-119

In resected portions of the stomach we find chronic atrophic gastritis of the corpus only in 10% of the patients with duodenal ulcers, and chronic inflammatory changes are, contrary to patients with a gastric ulcer, less marked. The difference is statistically significant. Consistent with some other authors, we find that great progression of chronic inflammatory changes occurs in patients operated on account of duodenal ulcers in the course of the first three years after operation. From six cases of regression of chronic inflammatory changes after operation, in two cases undetected atrophic gastritis was involved which was present in a severe form...

[Results of treatment of peptic ulcers using Gastrozepine and antacids in the endoscopic picture].

M Sorf, V Krislo, I Jablonský

Vnitr Lek 1989, 35(2):120-125

The authors investigated the therapeutic results in gastroduodenal ulcers in 96 patients treated with Gastrozepin (Slovakofarma), using daily doses of 75 mg combined with antacids. The examinations were made by means of a videogastroscope of Welch-Allyn Co. with subsequent control after four weeks, and if the ulcer was not healed, after two-week intervals. During the first examination they recorded the size of the ulcer and during check-up examinations the stage of healing. In a group of 51 men with a mean age of 44.4 years the incidence of duodenal ulcers was 29 cases (59.6%) and gastric ulcers 22 cases (43.1%). In a group of 45 women with a mean...

[Indications for liver resection].

M Procházka, M Veselá

Vnitr Lek 1989, 35(2):126-131

In a group of 103 resections of the liver made in 1978-1987 at the Surgical Clinic of the Medical Faculty of Hygiene, Charles University the authors evaluated the diagnostic possibilities of circumscribed hepatic lesions. They evaluated orientational and aimed methods which make it possible to plan the extent of the surgical operation. The diagnostic system elaborated by the authors makes it possible to outline the indications more accurately and serves the elaboration of the tactics of the operation proper.

[Determination of lactoferrin in the diagnosis of diseases of the pancreas].

P Dítě, M Bártová, V Skaunic

Vnitr Lek 1989, 35(2):132-136

In 29 patients with chronic pancreatitis, 15 patients with malignant tumours of the pancreas and in 30 controls lactoferrin in fluid aspirated from the duodenum was assessed during the cholecystokinin-secretin (CCK-S) test. As compared with the control group, its concentration is significantly higher in patients with chronic pancreatitis, but not in patients with malignant tumours of the pancreas. It is probable that estimation of lactoferrin in the CCK-S test may prove helpful in the differential diagnosis of pancreatic disease.

[Evaluation of long-term immunotherapy in patients with lupus nephritis].

D Zitnan, J Lukác, J Rovenský

Vnitr Lek 1989, 35(2):137-144

In 177 patients with lupus nephritis in the course of three decades three methods of immunotherapy were used the effect of which was evaluated retrospectively. When the criterium of the survival period was used, it was revealed that from a group of 66 patients treated only with glucocorticoids (mainly prednisone by the oral route) less than 60% survived five years the onset of lupus nephritis, only 33% survived 10 years. From a group of 81 patients treated with glucocorticoids and cytostatics (mostly cyclophosphamide by the oral route) 80% survived five years and 50% ten years, while in a group of 30 patients treated with glucocorticoids, cyclophosphamide...

[Pharmacologic restoration of sinus rhythm in atrial flutter and fibrillation].

J Vainer, J Smíd, H Cepeláková, J Hapala, I Topinka, O Topolcan

Vnitr Lek 1989, 35(2):145-150

Restoration of the sinus rhythm in atrial fibrillation and flutter can be achieved by cardioversion, using an electric discharge, or by medicamentous treatment. Medicamentous treatment is based above all on a combination of antiarrhythmic drugs. By the concurrent administration of quinidine, verapamil and digoxin restoration of the sinus rhythm is achieved in 80% patients, on average after 37 hours at plasma quinidine levels of 2.57 +/- 1.4 (SD) micrograms/ml and digoxin levels of 1.90 +/- 1.3 (SD) nmol/l. Restoration of the sinus rhythm in atrial flutter calls for higher quinidine and digoxin levels than in atrial fibrillation (p less than 0.01)....

[Frequency of carcinoma in thyroid cysts].

V Brozková, J Důra, V Cepelák

Vnitr Lek 1989, 35(2):151-157

The view that cystic thyroid nodes are as a rule benign is disproved by reports from the recent literature which quote an incidence of 17-32% of malignancies in conjunction with thyroid cysts. In 66 patients, investigated by the authors, with thyroid lesions confirmed on biopsy four suffered from thyroid carcinoma (two follicular, one papillary and one solid to anaplastic), i.e. a malignancy in 6%. In the literature it is recommended to follow up on a long-term basis patients with cysts which after thin-needle biopsy do not recede adequately or refill. Biopsies must be repeated, as the cytological yield of biopsies in these instances is not as reliable...

[Light reflex rheography--a new examination method in phlebology].

J Bizon

Vnitr Lek 1989, 35(2):158-163

The author discusses a new non-invasive method of examination of the venous system of the lower extremities. He explains the physical principle of the method and the practical procedure. He describes the curve in subjects with a healthy venous system and the curve in different grades of venous insufficiency. The diagnostic value of the examination, in particular in combination of native and occlusion tests, is emphasized. One advantage is that the apparatus can be connected with a ultrasonic flowmeter and thus the acoustic signal can be recorded on paper. By combining these two methods, the majority of venous diseases can be diagnosed by non-invasive...

[Cholecystolithiasis and ultrasonography. Is "technologism" possible in medicine?].

J Bielik

Vnitr Lek 1989, 35(2):164-167

The term "technologism" is used for a phenomenon where inadequate evaluation of the patient's condition may lead to an excessive number of auxiliary examinations, with a possible incorrect interpretation of their results and a possible inadequate final solution. On analysis of ultrasonographic examinations of the gallbladder the author considered as inadequate evaluation of biliary dyspepsia on account of the high incidence of cholecystolithiasis - 55.6% in men and 48.7% in women, biliary colic in men because of the low incidence of cholecystolithiasis - 32.0% and abdominal colic in women on account of the high incidence of cholecystolithiasis - 52.4%....

[Various clinical courses of hypersensitivity vasculitis with eosinophilia].

M Jíra, J Strejcek, E Antosová, D Singerová, V Rejholec

Vnitr Lek 1989, 35(2):168-174

The authors present three case-histories of patients who were followed up for prolonged periods and where the diagnosis of hypersensitive vasculitis was made. During the follow up period it was not possible to prove development into a different group of vasculitis or to detect a hitherto latent associated disease. Another common sign of the investigated patients was eosinophilia repeatedly found in peripheral blood, bone marrow and tissues. According to clinical criteria the above patients could not be included in groups of known types of vasculitis which are associated with eosinophilia. The patients differed significantly as to clinical manifestations...

[Diabetes insipidus as the first cause of myelodysplastic syndrome].

V Krislo, M Steruská, M Krislová, V Bezdek

Vnitr Lek 1989, 35(2):175-178

The concurrent occurrence of myelodysplastic syndrome and diabetes insipidus is very rare. In the available literature so far only three cases were described. In acute leukaemia the concurrence of the two diseases is rare. The authors describe two cases of concurrent diabetes insipidus and myelodysplastic syndrome with typical clinical and laboratory symptoms. A 27-year-old man with refractory anaemia (according to the FAB classification of myelodysplastic syndrome) died after 10 months from complications of acute leukaemia. In a 58-year-old female patients with refractory anaemia after two years remission the condition deteriorated and developed into...

[Less common causes of chronic tubulointerstitial nephritis complicated by acquired Fanconi syndrome].

M Horácková, J Kamínková, M Polácková, J Osten, J Stejskal

Vnitr Lek 1989, 35(2):179-183

The authors describe an uncommon form of the disease in a 25-year-old man who developed renal failure on the background of tubulointerstitial nephritis combined with acquired Fanconi syndrome. The authors analyze in detail the results of the laboratory examination and present differential diagnostic reflections which lead, after elimination of other possibilities, to the final diagnosis of immunity-mediated, viral antigen-conditioned tubulointerstitial nephritis.

[Diagnostic importance of QRS voltage].

J Cernohorský

Vnitr Lek 1989, 35(2):184-190

Voltage criteria of QRS are considered one of the signs of left ventricular hypertrophy. An increase of the R wave above the left precordium after a load is considered a manifestation of left ventricular ischaemia and evidence of coronary heart disease, but also a criterium of left ventricular function the volume of which increases as a result of altered haemodynamics. The voltage criteria of left ventricular hypertrophy are, however, of low sensitivity and specificity, as indicated by anatomical and echocardiographic investigations. The tracing of the electric field on the heart surface is not only influenced by the heart as a generator of electric...


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