[Autoimmune mechanisms in endocrinology--the polyglandular autoimmune endocrine syndrome].

J Hrnciar, M Hrnciarová

Vnitr Lek 1991, 37(6):521-530

Autoimmune endocrinopathies belong to so-called organ specific autoimmune diseases. These diseases combine very often and from the polyglandular autoimmune endocrine syndrome (PAES), where autoantibodies either destroy or stimulate individual endocrine glands or hormone receptors in target tissues. Thus a wide range of combinations of hypofunctional or hyperfunctional clinical syndromes develops. PAES is a good natural model of endocrine polyautoaggressiveness. In its development the following aetiopathogenetic factors participate: 1. Hereditary familial disposition, expressed e.g. by certain inherited HHS genes (e.g. A1, B8, DR 3, 4). 2. Aberrant...

[The effect of hemodialysis on potassium excretion by residual nephrons].

O Schück, V Teplan, H Nádvorníková

Vnitr Lek 1991, 37(6):531-534

In 19 patients with chronic renal failure and still preserved residual diuresis the inulin clearance (Cin) and renal potassium excretion were assessed before and 12 hours after haemodialysis (HD), combined with conventional ultrafiltration. The mean value of Cin after HD declined significantly (p less than 0.001). As a result of HD a significant decline of the plasma potassium concentration occurred (p less than 0.005) and of the urinary excretion (p less than 0.01). The mean value of the fractional potassium excretion (FEK) did not change significantly as a result of HD. The reduced urinary K excretion after HD correlated significantly (p less than...

[Determination of quantitative proteinuria from a single urine sample based on the protein:creatinine ratio].

A Jarosová, V Temlík, V Monhart

Vnitr Lek 1991, 37(6):535-540

Assessment of quantitative proteinuria is associated with collection of urine over several hours. This is, however, not always possible, in particular in ambulatory patients. Therefore efforts are made to assess the urinary protein per 24 hours on the basis of the proteinuria index, i.e. the ratio protein:creatinine in a single urine specimen. In a group of forty patients the authors demonstrated the closest correlation (correlation coefficient = 0.910374) between quantitative proteinuria and the index of proteinuria in urine specimens which were collected during daily activity. The closeness of this correlation depends on renal function. Assessment...

[The effect of alcohol on the mitochondrial respiratory chain in the cardiac muscle].

A Gvozdjáková, J Kucharská, E Miklovicová, P Bozek, J Gvozdják

Vnitr Lek 1991, 37(6):541-547

The authors investigated the action of prolonged 2- and 3-week action of ethanol on the main parameters of oxidative processes and on the cytochrome content of mitochondria in the heart muscle in 3-month-old rats. They found a statistically significant reduction of the oxidative phosphorylation coefficient, the rate of energy formation and a transient increase of the cytochrome oxidase activity in mitochondria. Under these experimental conditions an increase of cytochromes (cyt aa3, b, c, c1, bc1, c + c1) in mitochondria of the heart muscle occurred.

[Programmed ventricular stimulation in the evaluation of the clinical significance of premature ventricular contractions].

M Pleskot, V Pidrman, P Tilser, M Pospísil, A Strasová, M Pilc, P Rehor

Vnitr Lek 1991, 37(6):548-556

The authors subjected 34 patients (27 men and 7 women) to invasive electrophysiological examination. All patients had early ventricular contractions class 3-5 according to Lown which were recorded during ECG monitoring in bed or by Holter's system. A pathological excitability of the ventricular myocardium was found during programmed stimulation in 29% of the subjects. The excitability of the heart muscle was substantially enhanced by the incidence of ischaemic heart disease and reduced left ventricular function. The decreased frequency and severity of early ventricular contractions during bicycle ergometry, the absence of palpitations and syncopes...

[Diagnosis of diabetes mellitus based on the renal biopsy].

I Slugen, J Bucek, A Kovác, E Slugenová, M Pauer, P Fiala

Vnitr Lek 1991, 37(6):557-562

In a total of 1499 representative renal biopsies 30 displayed morphological changes suggesting diabetic nephropathy. Six patients had clinically diagnosed diabetes at the time of biopsy, 20 according to the bioptic finding, and in four patients the examination did not confirm diabetes. The authors describe the morphological vascular changes in particular the cumulation of masses resembling the mesangial matrix and basal membranes, as well as hyaline lesions, their development, site and combinations. In the author's opinion the most reliable sign of early diabetic nephropathy is thickening of the glomerular basal membrane. They draw attention to the...

[Platelet satellitosis].

V Fábryová, W Bürgi, E Brugger

Vnitr Lek 1991, 37(6):563-571

Platelet satellitism (PS) is a rare phenomenon described sporadically in the literature. It involves adhesion of thrombocytes sensitized by antibodies to leucocytes and is observed in vitro in EDTA anticoagulated blood. The authors' contribution to the problem is the observation of special thrombocyte aggregates surrounding neutrophils resembling comet tails, as well as the fact that the authors observed the formation of aggregates surrounding also lymphocytes and eosinophil cells.

[Increased numbers of large granular lymphocytes in the peripheral blood in selected inflammatory rheumatic diseases].

J Rovenský, J Tóth, L Rauová, J Lukác, D Zlnay

Vnitr Lek 1991, 37(6):572-577

In six patients with selected inflammatory rheumatic diseases the authors found increased numbers of LGL in the peripheral blood. Concurrently in these patients an increase of lymphocytes with the CD57 sign was found. In one patient with rheumatoid arthritis more detailed analysis revealed a reduced number of lymphocytes with sign CD16. In this patient in the peripheral blood cells with signs CD3+ and CD57 were found and the function of NK cells was markedly reduced. The clinical course of the disease in the patients was severe, in particular in SLE, where in three patients the disease was associated with the development of lupus glomerulonephritis....

[The validity of laboratory tests in the diagnosis of alcoholism and alcoholic liver injury].

I Rusnák, M Zuffa, R Pullmann, V Lazar, J Benkovic

Vnitr Lek 1991, 37(6):578-584

The authors assessed the value of commonly available laboratory examinations for the diagnosis of suspected excessive alcohol intake and suspected liver damage by alcohol. They tested the validity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gammaglutamyl transferase (GMT), the blood sugar level, serum cholesterol, bilirubinaemia, ferrinaemia and mean corpuscular volume (MCV). The highest validity as regards sensitivity of the examination was recorded in the MCV with a sensitivity of 0.78 and examination of GMT with a sensitivity of 0.72. By combination of MCV and GMT in an alternative manner, the...

[Analysis of the use of gentamicin, cotrimoxazole and cephalosporin in selected hospitals].

V Krcméry, M Antal, J Grunt

Vnitr Lek 1991, 37(6):585-590

The authors investigated the administration of monitored antibiotics, i.e. gentamicin, cephalosporins and cotrimoxazol, as well as of other so-called not monitored antibiotics. The investigation was made in the same 10 hospitals in the Slovak Republic three times in the course of 15 years, i.e. in 1978, 1983 and for the last time in 1988. It was revealed that the number of therapeutic administrations of the monitored antibacterial substances in increasing. The excessive gentamicin administration persists in particular on neonatal, premature-infant and surgical departments. The authors evaluate as a positive feature that the structure of administered...

[Renin and aldosterone in the first 24 hours after acute myocardial infarct].

I Markuljak, J Květenský, S Funiak, V Záhradný, L Vladár

Vnitr Lek 1991, 37(6):591-596

The authors investigated the levels of plasma renin activity and aldosterone in patients with a fresh myocardial infarction during the first 24 hours of hospitalization. The values of plasma renin activity and aldosterone were correlated with values of the control group. At the time of admission to the clinic both hormones were significantly elevated, as compared with the control group, in plasma renin activity p less than 0.001 and in aldosterone p less than 0.01. During the subsequent time intervals, i.e. after 3, 6 and 24 hours, the values of plasma renin activity did not change substantially, while the aldosterone values declined during the 6th...

[Rheumatoid arthritis developing into systemic lupus erythematosus during long-term treatment with penicillamine and sulfasalazine].

S Rejchrt, Z Hrncír, E Pintérová

Vnitr Lek 1991, 37(6):597-603

A female patient with IgM RF seropositive rheumatoid arthritis according to criteria of the American Rheumatism Association was treated for 133 months with Penicillamine and for 17 months also with Sulfasalazine. Both types of treatment were discontinued because the patient developed symptoms meeting diagnostic criteria of systemic lupus erythematosus, as defined by the same society. Early recognition of this diagnosis was made possible by regular follow up of clinical and laboratory data (ANA, anti DNP, anti dsDNA, C3, C4 and others). Marked improvement, incl. improvement of the nephropathy, was recorded after pulsed treatment with methylprednisolone.

[New findings on the use of specific alpha-1 adrenergic blockers in the treatment of high blood pressure].

K Horký

Vnitr Lek 1991, 37(6):604-611

Adrenergic alpha-receptors blockers have been used for a long time in the treatment of hypertension. The use of original non-selective alpha 1-blockers was restricted by the occurrence of undesirable side-effects. Therapeutic interest in alpha-blockers was restored after the discovery of selective adrenergic alpha 1-blockers. Since 1976 when the first selective alpha 1-blocker, prazosine, appeared on the market a number of quinazoline derivatives was developed (terazosine, doxazosine, trimazosine) and non-quinazoline alpha 1-blockers (indoramine, ketanserine, urapidil etc.). Selective alpha 1-blockers normalize the BP by reducing the pathologically...

[Angiotensin-converting enzyme inhibitors in the diagnosis and treatment of kidney diseases].

R Dzúrik, V Dzúriková, K Stefíková

Vnitr Lek 1991, 37(6):612-619

The authors describe in a review the use of inhibitors of the angiotensin converting enzyme, in particular enalapril, in the treatment of nephrogenic hypertension, glomerulopathies without hypertension, renovascular hypertension with unilateral or bilateral stenosis of the renal artery and diabetic nephropathy. They draw attention to specific traits in the treatment of different disorders, risk of treatment and the ensuing tactics of indication, dosage and monitoring.

[Medicine in the life and work of Frantisek Hamza].

J Kohout

Vnitr Lek 1991, 37(6):621-623