Vnitřní lékařství, 1992 (vol. 38), issue 1
[Unstable angina pectoris and acute myocardial infarct].
J Lukl, P Heinc
Vnitr Lek 1992, 38(1):1-5
In the course of nine years the authors investigated in 3570 patients hospitalized on account of acute coronary syndrome associations between unstable angina pectoris (UAP) and a acute myocardial infarction (NMI). A total of 1732 patients were admitted with UAP and 1912 patients were hospitalized on account of a NMI. In 74 patients admitted with UAP a NMI developed during hospitalization and 21 of them died from the complication of infarction. The risk of development of NMI was thus in patients admitted with UAP 4.3% and the probability of death was 1.2%. Statistical analysis did not reveal a different risk of development of infarction or death when...
[Clinical interpretation of the character of mitral valve flow in relation to diastolic properties of the left ventricle].
R Spacek, P Niederle
Vnitr Lek 1992, 38(1):6-13
Based on their own experience and data in the literature the authors describe the Doppler method of evaluation of properties of the left ventricle. In patients with early disorders of the diastolic function, when above all relaxation of the left ventricle is affected, a reduced rate of early diastolic filling (E) is a typical finding. There is also compensatory increase in the rate of filling during auricular contraction (A) with the appropriate increase of the A/E ratio and the ratio of rate velocity integrals (TVIA/TVIE). At the same time the maximal flow through the mitral orifice is reduced during early diastole (PFR), the deceleration time is...
[Noninvasive evaluation of hemodynamics in changes in the atrioventricular interval in patients with dual-chamber pacemakers].
T Minarík, R Stípal
Vnitr Lek 1992, 38(1):14-20
The authors evaluated in 19 patients with Dual Chamber pacemakers, using pulsed Doppler echocardiography, changes of the cardiac output after stimulation type DDD with an A-V interval of 100, 150, 175 and 200 ms. They evaluated also haemodynamic changes when changing the stimulation programme type DDD to ventricular stimulation type VVI. The group of patients was characterized by a left ventricular ejection fraction of 50.3 +/- 9.1%, a dimension of the left atrium of 37.1 +/- 5.6 mm and a end diastolic left ventricular dimension of 52.8 +/- 3.9 mm. The highest values of the cardiac output were recorded in 11 patients with an A-V interval of 175 ms,...
[Endomyocardial biopsy].
J Fabián, J Horák, J Sochman
Vnitr Lek 1992, 38(1):21-26
The authors present ten years' experience with endomyocardiac biopsy of the heart (EMB) using the percutaneous, endovasal catheterization needle technique. EMB was performed in 314 patients, a total of 1362 biopsies, and for evaluation 5564 specimens of cardiac tissue were taken. Based on this experience the authors emphasize methodical principles which make expedient, rapid and safe collection of cardiac tissue specimens possible. They also mention the main indication criteria for endomyocardial biopsy. Endomyocardial biopsy is a valuable clinical examination method which, no doubt, holds its place in the series of diagnostic methods of modern cardiological...
[Cytosine arabinoside in low doses in the treatment of myelodysplastic syndrome. Czechoslovak MDS Cooperative Group].
R Neuwirtová
Vnitr Lek 1992, 38(1):27-32
The authors present an account of the therapeutic results with small doses of cytosine arabinoside--20 mg/m2/day--in 56 patients where in almost 10% of the patients long-term "complete" remission was achieved and in 22% partial remission. When very small doses were used, i.e. 5 mg/m2/day, only one partial remission was achieved in a total number of 10 patients. From analysis of the therapeutic results some practical conclusions can be drawn which are listed in the discussion. So far we do not know effective treatment of myelodysplastic syndrome and recommend therefore to test in suitable patients small doses of ARA-C, despite the fact that a favourable...
[Occurrence, diagnosis and therapy of beta thalassemia in Slovakia].
N Kostíková, A Sakalová, B Mudronová, M Ferenczová
Vnitr Lek 1992, 38(1):33-39
The authors draw attention to the prevalence of beta-thalassaemia in Slovakia, the rising trend of the disease, the occurrence of new cases of the disease in eastern Slovakia where the disease was not described previously. They draw attention to pitfalls of the diagnosis and treatment of beta-thalassaemia in Slovakia, the importance of molecular analysis of DNA globin chains of haemoglobin in the diagnosis of this serious condition. The authors paid major attention to the importance of prenatal diagnosis.
[Determination of lactoferrin in the diagnosis of pancreatopathy in patients with chronic kidney failure].
P Dítě, M Brátová, J Erben, J Zahradník
Vnitr Lek 1992, 38(1):40-44
The authors investigated in patients with renal disease the lactoferrin content in duodenal aspirate. The aspirate was obtained after previous stimulation of the pancreas with pancreozymin. Lactoferrin estimation is described in the literature as a sensitive examination of changes of exocrine pancreatic secretion. The authors provided evidence that by assessing lactoferrin it is possible to detect initial changes of reduced exocrine pancreatic capacity already in subjects who are on the waiting list of chronic intermittent haemodialyzation programmes (CHIDP); maximum increase of the lactoferrin content in the duodenal aspirate corresponds with the...
[Results of detection of hepatitis C virus antibodies (anti-HCV) in blood donors and selected patients].
J Nováková, G Pokorná, M Hrubisko
Vnitr Lek 1992, 38(1):45-48
The authors examined 509 donors for potential carriership of the virus of hepatitis C (HCV), using kits for the detection of anti-HCV. Concurrently they examined also 110 hameatological patients who had a major transfusion of blood, plasma and its derivatives. They found that in the so-called healthy population anti-HCV is present in 0.39%. In haematological patients, i.e. patients with frequent haemotherapy they detected 29 positive cases, i.e. 26.36%. The largest number of anti-HCV positive patients was in the group of haemocoagulopathies. The investigation confirmed the close association between haemotherapy and the transmission of HCV. The authors...
[Experience with 1000 sclerotizations of esophageal varices].
P Svoboda, J Ochmann, R Sefr, I Kantorová
Vnitr Lek 1992, 38(1):49-55
The authors submit the results of 1061 endoscopic sclerotizations of oesophageal varices in 183 patients. For sclerotization they used endoscopes of Olympus Co. at two-week intervals. Treatment was supplemented by administration of drugs reducing portal pressure. The number of complications associated with this treatment is very low. Serious life-threatening complications occur in much less than 1%. The authors consider endoscopic sclerotization of oesophageal varices after the first haemorrhage as the method of choice, in particular in combination with medicamentous treatment for reduction of portal pressure. They emphasize the necessity to perform...
[Hemorrhage into the digestive tract as a cause of death in patients after kidney transplantation].
B Hájková, J Erben, P Fixa, V Herout, J Zahradník, K Kabelác
Vnitr Lek 1992, 38(1):56-59
The authors investigated the prevalence, cause and possible prevention of haemorrhage into the gastrointestinal tract in 218 patients after transplantation of the kidney (TK). 1. Haemorrhage into the gastrointestinal tract after TK occurred in 32 patients incl. 53.1% who died. In the total mortality after TK haemorrhage into the gastrointestinal tract account for 15.7%. 2. The danger of haemorrhage into the gastrointestinal tract is increased in particular: in the early postoperative period (within one month after transplantation of the kidney), during acute rejection with declining function of the graft, in infectious complications, after graftectomy,...
[The significance of plasmapheresis in the treatment of acute liver failure].
A Pavelka, L Dobes, P Dobes, J Lesanic, J Zadrazil
Vnitr Lek 1992, 38(1):60-65
The authors describe the use of plasmapheresis in the treatment of acute hepatic failure in viral hepatitis with a fulminant course. Plasmapheresis was used with regard to severe trombocytopenia and manifestations of haemorrhagic diathesis. In the discussion they draw attention to the importance of supportive methods in the treatment of acute hepatic failure and to perspectives of liver transplantations in this context.
[New aspects of clinico-roentgenological evaluation of manifestations of motility disorders of the esophagus and esophagogastric junction].
A Mersten
Vnitr Lek 1992, 38(1):66-71
After a brief review of motility disorders of the oesophagus and oesophagogastric junction the authors present findings on the instability of the manifestations of impaired motility after a certain time interval in the same patient. These changes have an evolutional character and it is assumed that variants of the same pathological entity are involved. The picture of corkscrew oesophagus develops into a diffuse spasm of the oesophagus and finally into achalasia. In gastrooesophageal reflux the controversy concentrates on the finding of 24-hour continuous examination (pH-metry and manometry) and changes of the mucosal lining of the distal oesophagus....
[Successful selective electrical ablation of the retrograde pathway in atrioventricular nodal reentry tachycardia associated with syncope].
J Lukl, C Cíhalík
Vnitr Lek 1992, 38(1):72-78
A 55-year-old man was admitted to the intensive care unit on account of repeatedly occurring syncopes which developed at the peak of physical exertion. The attack was reproduced by exercise on a bicycle ergometer: the patient developed paroxysmal tachycardia with a narrow QRS and a frequency of 160/min leading after 20 sec. to severe hypotension and loss of consciousness. The same tachycardia caused by programmed atrial stimulation caused a drop of tension in the recumbent position by 30 mmHg and after more detailed analysis during electrophysiological examination it was evaluated as atrioventricular nodal reentrant tachycardia. By an electric discharge...
[Heart involvement in systemic scleroderma].
V Gunka, M Kulhánek
Vnitr Lek 1992, 38(1):79-85
Systemic scleroderma is a general disease of the connective tissue which may affect practically any organ. The authors describe the case of a man where in the course of the disease affection of the heart with symptoms of severe cardiac failure became the dominating symptom.