[Diastolic function of the left ventricle in incipient hypertension].

I Dvorák, H Nĕmcová, J Spác, M Blaha

Vnitr Lek 1989, 35(8):729-735

The authors provide evidence that changes of diastolic indicators precede in incipient hypertension the impaired left ventricular function. In marginal hypertonics and in particular in stage 1 hypertonics they found by echocardiography that, as compared with healthy normotonic subjects, sings of impaired relaxation in the early diastole. This is apparent from the significant prolongation of the time constant of relaxation at rest and the maximal speed of relaxation which are due to the early filling of the left ventricle. To increase the sensitivity of the echocardiographic examination of left ventricular functions the isometric loading test proved useful.

[Unstable angina pectoris--pathogenesis and therapy].

V Cervenka, V Vísek, P Widimský, J Dvorák, P Gregor, T Sládková, S Hrdlicka

Vnitr Lek 1989, 35(8):736-742

Unstable angina pectoris is a clinical syndrome characterized as a rule as rapid deterioration of angina or newly developed angina pectoris. The authors examined 30 patients with unstable angina pectoris who were admitted to hospital within 24 hours after the attack. Coronarography was performed on average after 14.6 hours. In all patients significant coronary stenoses were found. Streptokinase was administered into the coronary artery exhibiting the maximum narrowing in a total dose of 500,000 u. at a rate of 10,000 u/min. After streptokinase administration improvement of the coronarographic finding was recorded in 53% of the group, subjective improvement...

[Evaluation of the Q wave in leads II, III, and aVF. I. Deviation of the electrical axis of the heart, ischemic heart disease].

S Cagán, L Kuchárová

Vnitr Lek 1989, 35(8):743-751

The authors present a brief account of data reported in the recent literature on the evaluation of the Q wave in leads, II, III, aVF in clinically healthy subjects and in patients with ischaemic heart disease, in particular in conjunction with focal myocardial lesions. A marked Q wave in these leads is not necessarily a manifestation of clinical disease (it may be due to a changed position of the electric axis of the heart) and conversely the absence of the Q wave in leads II, III, aVF does not imply clinical absence of disease (most frequently a low myocardial infarction). It is not possible to differentiate Q waves in leads III and aVF into positional...

[Echocardiographic orientation evaluation of the function of the left heart ventricle].

I Dvorák, J Spác, M Blaha, H Nĕmcová, P Lupínek, O Bednarík

Vnitr Lek 1989, 35(8):752-757

The authors discuss the possibility to make use of a simple echocardiographic indicator of left ventricular function--the angle formed by the anterior cusp of the mitral valve and the line of the interventricular septum, assessed from a four-chamber tracing (angle M). Based on echocardiographic examination of 87 subjects they established their own standards. They consider values above 30 degrees as pathological, suggesting impaired left ventricular function. The M angle correlates significantly with invasive (final diastolic pressure in the left ventricle, ejection fraction) and with non-invasive (top speed of shortening of the circumferential fibre)...

[Clinical effects of isosorbide dinitrate in the transdermal spray (TD Spray Iso Mack) form].

J Vítovec, M Stejfa, M Blaha, H Nĕmcová, P Roubalík, J Spác

Vnitr Lek 1989, 35(8):758-764

The authors report on their experience with the transdermal spray, TD spray Iso Mack. Using a graded ergometric test, the authors examined 11 patients with angina on exertion before and 60 minutes after administration of 60 mg of the effective substance by the transdermal route. The average threshold of ischaemia and work tolerance increased significantly and the ECG depression of segment S-T receded. In an open trial six patients were investigated with angina on exertion during three-week treatment with the spray--twice a day 60 mg by the transdermal route--as compared with standard treatment. The number of attacks and consumption of sublingual nitroglycerin...

[Long-term therapy with the insulin pump].

B Podrouzková

Vnitr Lek 1989, 35(8):765-771

The author treated for prolonged periods 179 diabetics type I and II using an insulin pump. The shortest period of treatment was 6 months, the longest three years. Treatment failed only in six patients, i.e. in 3.3%, in all instances because they were incapable of adhering to the dietetic regime or to control the function of the pump. Complications had also mainly technical reasons, in 43 patients the pump failed and had to be replaced. Indicators of metabolic compensation reached normal levels in 173 patients and the triacylglycerol and cholesterol blood levels declined significantly. Laboratory hypoglycaemia was recorded in all patients, hypoglycaemia...

[Special problems in diabetics with hypertension].

J Rybka, J Mistrík

Vnitr Lek 1989, 35(8):772-779

Diabetes and hypertension are independent risk factors of coronary heart disease as well as of other cardiovascular diseases, and their combination substantially enhances the risk. Hypertension is twice to four times as frequent in diabetics than in the non-diabetic population. The most frequent form is essential hypertension which affects the relatively most numerous group of the II diabetics but may occur also in type I diabetics. Insulin dependent diabetics suffer more frequently from "renal diabetic hypertension" and tend to develop hyporeninaemic hypoaldosteronism. Other types of hypertension found in diabetics are systolic hypertension and hypertension...

[Prognosis in joint inflammation after acute respiratory diseases].

L Hrncírová, L Klabusay, V Vitulová

Vnitr Lek 1989, 35(8):780-787

A group of 25 patients with arthritis after acute respiratory disease (ARD) was followed up, on average for 4.7 years, with regard to the short-term and long-term prognosis. The patients developed arthritis 1-4 weeks after ARD and it affected mainly or exclusively the joints of the lower extremities, in particular the talocrural ones. After a mean period of five weeks the arthritis receded completely. 60% of the patients were HLA B27+, the number of affected joints in these patients was greater than in HLA B27- patients. HLA B27+ subjects are more likely to develop arthritis after ARD than HLA B27- subjects (relative risk = 6.35). In the long-term...

[Long-term observation of patients with isolated seropositivity for rheumatoid factor in the serum--clinical and immuno-rheumatological study].

V Vitulová

Vnitr Lek 1989, 35(8):788-794

A group of 40 subjects (33 women and 7 men) assembled in the course of several years comprised clinical and ambulatory patients. The main characteristic of the group was isolated seropositivity of rheumatoid factors assessed by the latex fixation test with titres of 1:320 and more in apparently healthy subjects. The mean age of the subjects at the beginning of the investigation was 39 years. They were followed up for 2-18 years, on average for 7.8 years. Regular clinical, biochemical and immunological check-up examinations were made after 1-2 year intervals. The latex fixation test was made in a test tube. The most serious manifestation was the development...

[The present level of control of hypertension in the South Moravian Region].

J Zicha, O Pálka, P Dobes, M Sír

Vnitr Lek 1989, 35(8):795-781

The authors present the results of a cross sectional and prospective investigation of hypertension in the South Moravian region. The inadequate control of high blood pressure is according to the authors due to inadequate screening, unsuitable dosage and selection of antihypertensive drugs, lack of confidence in medicamentous treatment, inadequate cooperation of doctors and patients, and frequently lack of perception of the disease. The authors mention also the importance of the unbalanced supplies in previous years. They refute objections that screening and treatment of hypertension is time consuming and expensive and consider prevention the prerequisite...

[Hyperinsulinemia in cirrhosis--increased secretion or impaired liver extraction?].

P Weber, K Martínek

Vnitr Lek 1989, 35(8):802-808

The authors applied the oral glucose tolerance test (oGTT) in 21 patients with bioptically confirmed cirrhosis without clinical or laboratory signs of manifest diabetes. At the same time they used the oGTT in 11 healthy controls. During the test they assessed the venous glycaemia, insulin and C-peptide and from these values they calculated relative indexes. In cirrhotic patients they recorded during the oGTT higher blood sugar levels, and higher insulin and C-peptide in the majority of time intervals [blood sugar during the 90th minute p greater than 0.01 and 120th minute p greater than 0.05; immunoreactive insulin (IRI) in the 90th minute p greater...

[The occurrence of endothelial cells in the blood in deep venous inflammation].

L Vacek, L Drápelová, L Hrncírová

Vnitr Lek 1989, 35(8):809-811

The number of anuclear residues of endothelial cells in the blood stream was investigated in 22 patients suffering from deep phlebitis and no other disease. The level of endothelaemia in these patients was in all instances higher than in 24 healthy subjects. Assessment of the endothelaemia in patients with deep phlebitis makes more accurate assessment of the diagnosis and the follow-up of regression of the disease possible.

[Errors in the evaluation of osteoarticular symptoms].

J Skricková, J Vorlícek

Vnitr Lek 1989, 35(8):812-815

The authors describe two patients with osteoarticular symptoms. In the first patient they were treated as rheumatic disease, and only after treatment had failed, a neoplastic aetiology was considered. In the second patient the authors considered the articular complaints from the beginning a paraneoplastic syndrome and only the subsequent course of the disease revealed that they were mistaken. It was rheumatoid arthritis with an atypical Caplan syndrome.

[Differential diagnosis of elevated myoglobinemia].

I Kurcová, V Umnerová

Vnitr Lek 1989, 35(8):816-820

The authors evaluate the value of examinations of myoglobinaemia as a biochemical indicator of some diseases. Clinically most significant is the transient rise of serum myoglobin levels in acute myocardial infarction. From the aspect of early diagnosis, investigation of the course of the disease and for evaluation of thrombolytic treatment the assessment of myoglobin is much more sensitive than hitherto used "cardiospecific enzymes". The authors mention other pathological conditions with damage of the cardiac tissue where elevated myoglobinaemia may be anticipated. In addition to cardiac affections the following conditions are associated with elevated...

[The history of hospital care of internal diseases in Prostĕjov].

I Gladkij, J Mrázek

Vnitr Lek 1989, 35(8):825-829