Vnitřní lékařství, 1990 (vol. 36), issue 10
[The effect of stimulated tachycardia on diastolic left ventricular filling in patients with ischemic heart disease].
R Spacek, I Hes, P Kozák, A Stárek, E Hausnerová
Vnitr Lek 1990, 36(10):937-943
The authors examined 20 patients with ischaemic heart disease (IHD) by pulsed Doppler echocardiography before and after a load of stimulated tachycardia. The character of left ventricular filling depended on the blood pressure reading in a wedged position only in patients who had an elevated pressure (r = -0.65 and r = -0.81 resp. after a load for A/E, r = -0.62 and r = -0.79 after a load for DT). When the pressure is normal, it declines in a wedged position and the left ventricular filling in early diastole becomes protracted and the ratio of the atrial filling rises (A/E increased after the load p greater than 0.001, DT was protracted after the load...
[Experience with permanent cardiac pacemakers in the East Slovakian Region 1978-1987].
B Stancák, J Resetár, J Bodnár, J Vajó, M Palinský, P Harbuµák, J Pella, M Vaµko, E Milichovský
Vnitr Lek 1990, 36(10):944-950
The authors present a group of patients where in the course of the 10-year period of 1978-1987 a permanent pacemaker was implanted. 587 primary implantations were made and 327 exchanges of cardiac pacemakers. The mean age in the group of primary implantations was 70.4 +/- 10.3 years, in the group of exchanges 70.4 +/- 10.6 years. n 98.8% pacemakers VVI and VOO made in Czechoslovakia were implanted. Indications for primary implantation were in 64% atrioventricular block (AV) grade III, in 11% AV block grade II, in 22% disease of the sinoatrial node and in 4% other dysrhytmias. The age category above 60 years accounts for 85.5% in the group of primary...
[Recording of monophasic action potentials using a contact catheter in humans. Preliminary report].
J Vojácek, J Slavícek, M Novák, M Psenicka, J Humhal, P Krupicka
Vnitr Lek 1990, 36(10):951-957
Investigations of a monophasic action potential (MAP) at a cellular level in experiments provided basic findings on the course of the electric activity in cells in various cardiac compartments and tissues under physiological conditions and various pathological states and has become an indispensible part of the evaluation of electrophysiological properties of various cardiovascular drugs, in particular antiarrhythmic drugs. A record corresponding to the MAP can be obtained also from the surface of the human endocardium during catheterization by means of a Franz contact catheter. MAP is induced by pressure depolarization after applying the catheter to...
[Ventricular tachycardia in patients with arrhythmogenic right ventricular dysplasia. Electrophysiologic characteristics and testing of the effectiveness of anti-arrhythmia therapy].
J Hluchý, V Milovský, H Uhliariková, M Pavlovic, J Kasper, I Riecanský
Vnitr Lek 1990, 36(10):958-968
The authors present a clinical and electrophysiological characteristic in two cases of symptomatic sustained ventricular tachycardia (VT) with a QRS morphology of left bundle branch block, refractory to common antiarrhythmic treatment. It was confirmed that the mechanism of this arrhythmia associated with a high risk of sudden death is the reentry phenomenon and the authors analyzed its relationship to arrhythmogenic dysplasia of the right ventricle. In a way uncommon in our literature the authors demonstrate the importance of comprehensive electrophysiological examination in these serious cases and its usefulness in confirming the origin of VT in...
[A proposal for a standardized protocol for echocardiographic examinations of valvular defects, valve prostheses and atrial septal defects].
M Bělohlávek, V Vondrácek
Vnitr Lek 1990, 36(10):969-977
The authors summarize in standard protocols the spectrum of possible examinations made by means of a modern echocardiographic apparatus in valvular defects and prostheses and in septal atrial defects. They discuss some evaluations and their practical importance. Standardization contributes towards a comprehensive and more illustrative character and facilitates comparison of findings. A structured concept of the protocol is selected with the perspective of its deposition in a data base of an interactive external computer. The work should serve as a stimulus for discussion in other echocardiographic departments and elaboration of their own working procedure.
[Comparison of the therapeutic effectiveness of membrane and centrifugation plasmapheresis].
K Opatrný, H Pittrová, K Opatrný, P Kováríková, M Cerhová, H Rusnáková
Vnitr Lek 1990, 36(10):978-984
The authors compared 10 pairs of membrane plasmaphereses on an apparatus A 2008 PF and filter Plasmaflux P 2 with 10 centrifugation plasmaphereses on an apparatus Fenwal CS 3000. They evaluated the effectiveness by changes of plasma concentrations of total protein, albumin, beta 2 microglobulin, IgG, IgA, C3 complement, IgM, circulating immune complexes, urea, creatinine, uric acid, cholesterol, triacylglycerols and the clearance of these substances. Changes of plasma concentrations caused by plasmapheresis with the methods used did not differ in any of the investigated substances. The clearance of membrane plasmapheresis was for all substances higher...
[Use of the computer for the evaluation of platelet aggregation].
J Hejl, N Hejlová, K Zelnícek
Vnitr Lek 1990, 36(10):985-990
The authors describe some methods of evaluation for platelet aggregation. Because the approaches are different, frequently some results of aggregation in pathological conditions differ. The authors give an account of their method of evaluation of platelet aggregation by means of a small personal computer.
[Neuroglycopenic syndromes in malignant tumors].
J Hrnciar
Vnitr Lek 1990, 36(10):991-997
Based on observations of five of own patients the author analyzes the causes of spontaneous hypoglycaemia in malignant tumours and assumes three mechanisms of development: 1. Metastatic affection of the liver reduces the reserves of homeostatically usable glycogen and can reduce also the amount of utilized insulin and glucagon, and this weakens the effectivity of contraregulating hormones. 2. In case of large mesenchymal tumours it is assumed that the cause of hypoglycaemia is the neoplastic formation of IGF II. For these hypoglycaemic states a low concentration of C-peptide, IRI (immunoreactive insulin), absence of response of growth hormone to hypoglycaemia,...
[Problems in the early diagnosis and treatment of colorectal carcinoma and adenoma in the aged].
V Zoubek, H Zoubková, M Mrůzek
Vnitr Lek 1990, 36(10):998-100
In 1985-1989 in the Bruntál district by means of the test for occult haemorrhage (Haemoccult, Röhm Pharma Co.) a total of 1084 subjects aged 65-86 years were examined. The test was positive in 74 subjects (6.83%). A subsequent coloscopic examination was made in 60 subjects, 81% of those with a positive test. Coloscopic examination revealed 8 patients with carcinoma of the large intestine and 45 patients with an adenomatous polyp. The oncological positivity is thus 4.89% of the tested subjects and 88.33% of those subjected to coloscopy. The carcinoma was evaluated in two cases in the stage Dukes A, in four instances in stage Dukes B, in one case in...
[Pseudoobstruction syndrome of the large intestine (endoscopic therapy)].
V Vráblik, M Pavlovic, P Filípek
Vnitr Lek 1990, 36(10):1002-1004
The authors present an account on the successful treatment of pseudoobstructive syndrome of the large intestine (Ogilvie syndrome) by decompression, which was achieved by inserting a catheter by means of a coloscope into the transverse colon or caecum. The authors used this method in two patients.
[Successful treatment of the superior vena cava syndrome caused by thrombosis and a fibrous septum in a patient with a permanent cardiac pacemaker].
J Bastecký, A Hlava, V Brzek, V Rozsíval, L Chrobák, J Kvasnicka
Vnitr Lek 1990, 36(10):1005-1010
A patient with a ten-year permanent implantation of a pacemaker was admitted on account of a clinically serious syndrome of the vena cava superior. The cause of the syndrome was an angiographically confirmed extensive thrombosis and after its dissolution a fibrous septum in the area of the orifice of the vena cava superior into the right atrium. The septum caused by a fibrous strip at the orifice of the vena cava superior into the right atrium was removed by surgical operation during thoracotomy by dilatation of the original opening in the fibrous septum by a Broca dilator and digitally. The authors recommend, based on their own experience and data...
[Evaluation of diastolic left ventricular function using pulsed Doppler echocardiography].
M Vítovec, P Frídl
Vnitr Lek 1990, 36(10):1011-1017
The authors give an account of the evaluation of diastolic functions by means of pulsed Doppler echocardiography. It is a relatively new method which is still seeking its position in the pattern of examinations. However, some authors have already demonstrated that it is valuable and can contribute towards a more accurate description of the functional state of the myocardium and help to detect initial stages of disease. As it is non-invasive, it can be repeated, as required without damaging the patient and thus can be used to follow up the effect of therapy.
[Human immunodeficiency virus infection and rheumatology].
F Mateicka
Vnitr Lek 1990, 36(10):1018-1024
The most important rheumatologic manifestations associated with infection with human immunodeficiency virus are described. Among arthritides, Reiter's syndrome, psoriatic arthritis, and some forms of reactive arthritis are the most common. Arthralgias are also relatively frequent. Manifestations of polymyositis, vasculitis and sicca syndrome with a relatively broad spectrum of various autoimmune phenomena are also very important. The author emphasizes the importance of interdisciplinary cooperation of internists, rheumatologists, infectionists and virologists in solving questions associated with laboratory and clinical aspects of the relationship between...
[Human immunodeficiency virus infection and the pathogenesis of AIDS].
J Krejsek, B Fixa
Vnitr Lek 1990, 36(10):1025-1029
The prerequisite of effective infection with the virus of human immunodeficiency (HIV) are the interaction between the CD4 complex of the susceptible cell and outer glycoproteins of the virus. The CD4 complex is found above all on the sub-population of helper inducer T lymphocytes and cells of the monocyto-macrophage line. These interactions are essential for the penetration of the virus into the cell and participate also in the fusion of infected and non-infected cells which is typical for HIV infection. The outer layer glycoproteins of HIV are immunogenic, however, the antibodies which are formed do not neutralize the virus. It is even probable that...
[Use of nonparametric methods in medicine. V. A probability test using iteration].
A Gerylovová, J Holcík
Vnitr Lek 1990, 36(10):1030-1037
The authors give an account of the so-called Wald-Wolfowitz test of iteration of two types of elements by means of which it is possible to test the probability of the pattern of two types of elements. To facilitate the application of the test five percent critical values are given for the number of iterations for left-sided, right-sided and bilateral alternative hypotheses. The authors present also tables of critical values for up and down iterations which are obtained when we replace the originally assessed sequence of observations by a sequence +1 and -1, depending on the sign of the consecutive differences. The application of the above tests is...