[Mutual interaction of the renin-angiotensin system and the atrial natriuretic factor in the renal response to acute volume loading].

K. Horký, V. Tesar, I. Gregorová, J. Srámková, J. Dvoráková

Vnitr Lek 1990, 36(7):625-632

The authors investigated dynamic changes and the interaction of the plasma renin activity (PRA), plasma aldosterone (PAC), i.e. the main representatives of sodium retaining systems, and of the atrial natriuretic factor (ANF) the decisive natriuretic substance in acute expansion of the extracellular volume (ECV) by infusion of two litres of saline in six controls, seven patients with essential hypertension and liver cirrhosis without ascites (6 patients) and with ascites (6 patients). The expansion evoked controversial changes of these systems. It led to a rise of ANF and suppression of PAC and PRA. Although ANF rose after infusion to the roughly similar...

[Echocardiographic control of treatment of mild hypertension with trimepranol].

I Oral, H Vizinová

Vnitr Lek 1990, 36(7):633-638

Forty men with hypertension, diastolic BP lower than 14.66 kPa, were treated for six months with Trimepranol, 10 mg three times per day, with echocardiographic checking of changes of the cardiac minute output and the peripheral vascular resistance at rest and during an isometric load. In patients with a low baseline vascular resistance (group A, n = 20) a substantially better therapeutic effect was recorded than in patients with a markedly elevated peripheral resistance (group B, n = 11). Trimepranol is indicated in patients with a higher heart rate at rest and with a significant increase of the latter during isometric loading tests.

[Left ventricular ejection fraction estimated by 2-dimensional echocardiography].

J Hůla

Vnitr Lek 1990, 36(7):639-642

Visual assessment of the reduction of left ventricular volumes during the cardiac cycle, which is the basis for calculation of the left ventricular ejection fraction followed up from several planes in real time is close to the objectively assessed changes estimated by various time consuming methods from two-dimensional echocardiography by the one- or two-plane method. The author's method makes it possible to assess the left ventricular ejection fraction and to divide it for clinical needs into four groups: normal above 60%, slightly reduced 45-60%, reduced 30-45% and markedly reduced 30% or less. The described echocardiographic examination method is...

[Diagnosis of the heterozygote carrier state in 21-hydroxylase deficiency using steroids].

J Sulcová, R Hampl, L Foretová, V Vána, L Stárka

Vnitr Lek 1990, 36(7):643-648

In an attempt to elaborate a method for screening heterozygous carriers of inborn adrenal hyperplasia caused by insufficiency of steroid 21-hydroxylase, the authors examined in 24 obligatory heterozygotes and in seven controls the concentrations of four steroids. Cortisol (F), 11 beta-hydroxyandrostendione (11-OH), 17 alpha-hydroxyprogesterone (17-OH) and androstendione (A) were estimated by the RIA method using non-commercial antisera. In the examined subjects an abbreviated ACTH test was made and the mentioned parameters were assessed at times 0, 30 and 60 minutes. The results (nmol/l) were expressed by the relationship R = F.11-OH/17-OH.A for all...

[The effect of smoking on menopause].

M Tajtáková, E Farkasová, M Klubertová, I Konrádová, L Machovcáková

Vnitr Lek 1990, 36(7):649-653

The authors investigated the age of onset of the menopause by random selection, using a questionnaire, in 344 women aged 43 to 90 years in relation to smoking. They evaluated 107 non-smokers, 112 passive smokers, and 118 active smokers. The mean age of onset of the menopause in non-smokers was 49.8 +/- 4.1, in passive smokers 49.1 +/- 4.9 and in active smokers 48.1 +/- 4.3 years. Active smokers had their menopause on average by 1.7 years sooner than non-smokers (p less than 0.01). This difference depended on the duration of smoking and increased with the number of smoked cigarettes to as much as 2.4 years in smokers of greater than 20 cigarettes per...

[The prevalence of bronchial asthma in a selected sample of the adult Prague population].

V Vondra, J Prazáková, M Reisová, H Mazáková, J Balý, A Machová, B Fuchs, J Jíra

Vnitr Lek 1990, 36(7):654-659

The authors assessed the prevalence of bronchial asthma in 8458 18-year-old and older inhabitants of an economic area in Prague 8. The population of the area up to December 31, 1987 was 90,458 adults. The health communities were selected in a random way to comprise the central as well as peripheral parts of Prague 8. By means of questionnaires information was assembled from 70.9% of the respondents and after supplementation of data by various doctors the scope of information was 89.9% (7605/8458). For detailed examination 902 subjects were selected with "confirmed" and suspect symptoms of asthma. The anamnestic data were analyzed and pulmonary ventilation...

[Development of disorders of glucose tolerance in the offspring of diabetic parents].

L Dvoráková

Vnitr Lek 1990, 36(7):660-668

The author investigated the development of abnormalities in the glucose tolerance in 70 subjects, 36 men and 34 women, where both parents were type II diabetics. The mean age of the offspring was 35.2 +/- 7.4 years, the mean follow up period 8.7 +/- 3.9 years. In the present work the blood glucose level and serum insulin after an oral glucose tolerance test are evaluated and compared with the results of tests of a matched control group of 37 healthy subjects without a family-history of diabetes. Based on repeated examinations the group was divided into sub-groups: with a repeatedly normal glucose tolerance (38%) and sub-groups where at least once a...

[Early diagnosis of nephropathy in type I diabetics].

H Polácková, H Platilová, L Dvoráková, E Hájková, J Nedvídková, P Stolba

Vnitr Lek 1990, 36(7):669-675

In 68 type I diabetics without permanent proteinuria, mean age 28 +/- 9 years, where diabetes was detected at the age of 14 +/- 7 years and persists for 14 +/- 8 years the urinary excretion of albumin and beta-2-microglobulin was assessed. The results were evaluated in relation to the persistence of diabetes, the blood pressure reading, family-history of diabetes and type of insulin therapy. In addition to microalbuminuria in 29% of the subjects which is a manifestation of glomerular damage, the authors detected in 58% elevated beta-2-microglobulin excretion indicating early changes of the proximal tubule. There was a relationship between microalbuminuria...

[The ISIINR computer program for laboratory standardization of the prothrombin test].

J Berger

Vnitr Lek 1990, 36(7):676-679

Expression of results by means of INR is a clinically important standardization of the prothrombin test. The INR values of healthy subjects are as a rule within the range of 1.0 and 1.2. Calibration of thromboplastin and processing of the results of the prothrombin test is facilitated by the computer programme ISIINR.

[Familial incidence of diffuse idiopathic skeletal hyperostosis].

S Havelka, R Fáberová, J Gatterová, K Trnavský

Vnitr Lek 1990, 36(7):680-684

The authors describe the incidence of diffuse idiopathic skeletal hyperostosis in three members of a family--father and two daughters. Some diagnostic problems of the disease are also discussed.

[Transesophageal echocardiography--new possibilities of peroperative monitoring of cardiac hemodynamics].

M Kozáková, L Matuszczyková

Vnitr Lek 1990, 36(7):685-692

The authors describe a new method of monitoring of the heart during operation--Intraoperative transoesophageal echocardiography (TEE). They discuss the influence exerted on the cardiovascular system by anaesthesia and surgery and the possibility of echocardiography to record their consequences. The authors describe briefly the technique of this monitoring, possibilities how to evaluate the global and regional function of the left ventricle, the cardiac output, preload. They compare intraoperative transoesophageal echocardiography with invasive methods used for monitoring of cardiac function during operation.

[Diabetic osteopathy. 5. Prevention].

J Kocián

Vnitr Lek 1990, 36(7):693-698

The author presents an account on possibilities of prevention of osteoporosis and osteomalacia in diabetics by eliminating or reducing some causes which lead to these complications. In osteoporosis this involves a modified diabetic diet, burdening of the bones by suitable exercise, compensation of diabetes and screening and treatment of complications of diabetes. Prevention of osteomalacia in diabetics includes according to the author adequate exposure to ultraviolet rays which ensures an adequate amount of vitamin D in the skin, dietary measures and administration of vitamin D, treatment of complications of diabetes and methods of mobilization of...

[Vitamin D and the immune system].

I Porsová, M E Chauveau, J Blahos

Vnitr Lek 1990, 36(7):699-703

The authors draw attention to the contemporary broad concept of the vitamin D endocrine system comprising in addition to the gut, bones and kidneys, some other tissues and cells incl. cells of the immune system. They give an account of findings on receptors for the active hormonal metabolite of vitamin D, 1,25-dihydroxycalciferol [1,25(OH)2D], in the cells of the immune system and summarized contemporary ideas on the mechanism of action of 1,25(OH)2D in these cells. They discuss the role of 1,25(OH)2D in non-specific and specific immune processes, and based on data from the literature and results of their own experimental work, they evaluate the possibility...

[Cor pulmonale and cor pulmonale decompensation--what is the future of these terms?].

J Widimský, V Jezek

Vnitr Lek 1990, 36(7):704-709

Decompensated cor pulmonale is a clinical syndrome manifested by signs of congestive heart failure in pulmonary disease. The authors emphasize that the haemodynamic characteristic of the syndrome differs substantially from the classical picture of chronic heart failure: the cardiac output is usually normal at rest and sometimes even during exercise, signs of impaired contractility of the right ventricle are absent and the effect of cardiac glycosides is minimal. It is possible that the clinical syndrome of decompensated cor pulmonale is caused mainly by respiratory failure and subsequent impaired function of some organs, in particular the kidney.

[Use of nonparametric methods in medicine. II. Comparison of levels in 2 related samples].

A Gerylovová, J Holcík

Vnitr Lek 1990, 36(7):710-716

The authors present two non-parametric tests which are suitable for comparison of the level of a random variable on the basis of results obtained from two dependent samples. The sign test is discussed which is based on the evaluation of the statistical significance of the difference in the number of positive and negative deviations. The application of this test in practice is facilitated by the enclosed table which gives critical frequencies which still lead to the refusal of the zero hypothesis. The authors discuss also Wilcoxon's test for paired values. This test takes into account not only the trend of deviations but also their magnitude and thus...

[International Forum for the Evaluation of Cardiovascular Therapy--Lisbon, Portugal, March 3-6 1990].

J Widimský

Vnitr Lek 1990, 36(7):720-725

[Balneology].

M Skapík

Vnitr Lek 1990, 36(7):726-727