Vnitřní lékařství, 1992 (vol. 38), issue 6
[Disorders of circulation regulation and heart disease].
Z Fejfar
Vnitr Lek 1992, 38(6):521-524
Functional disorders of the circulation imply an inadequate circulatory response to repeated, in particular mental strain, associated with typical complaints and manifestations. Instead of the formerly used term of neurocirculatory asthenia nowadays neurotic conditions with manifestations in the circulation are described more frequently as hyperventilation syndrome, syndrome of chronic fatigue or panic anxiety syndrome. The paper deals with the pathogenesis, diagnosis, prognosis and therapy where a talk with the patient, elucidating the relationship between the stressing situation and circulatory manifestations is most important.
[Transesophageal stress echocardiography].
I Dvorák, J Spác, H Nĕmcová, M Blaha, O Hlinomaz
Vnitr Lek 1992, 38(6):525-530
The authors submit their initial experience with the work protocol of transoesophageal loading echocardiography, which they used in 148 patients. The method is meant in the first place for individuals where the records of classical transthoracic echocardiography in 10-25% are difficult to visualize by echocardiography or patients who for any reasons cannot be subjected to common loading examinations. The informative capacity of this method is almost 100%. It makes it possible to evaluate every accurately filling and ejection indicators as well as changes in the motility of cardiac walls.
[Noninvasive diagnosis of coronary spasm].
J Bultas, D Karetová, M Aschermann, P Krupicka, V Danzig, S Simek
Vnitr Lek 1992, 38(6):531-540
The objective of this work was to compare the sensitivity of non-invasive tests used for the diagnosis of variant angina pectoris (VAP). In a group of 38 patients with VAP the authors compare the sensitivity of the cold test (CT), hyperventilation test (HT), handgrip (HG), bicycle ergometry (BE) and a newly suggested combination of hyperventilation with HG and BE resp. The authors evaluated first the sensitivity of ST elevations which are an entirely specific sign and in particular denivelization of ST (by depression or elevation) which is a less specific sign. The sensitivity of different tests was as follows: CT 5% and 5% resp., HT 18% and 39% resp.,...
[Echocardiographic indicators in various stages of hypertension and their relation to the incidence of dysrhythmia].
B Stancák, A Mihalíková, J Pella, K Belesová, D Macková, P Cizmárik
Vnitr Lek 1992, 38(6):541-547
The authors present a group of 143 hypertonic patients divided into three subgroups by the stage of hypertension (WHO). The objective was to detect an association between the incidence of cardiac dysrhythmias and the stage of hypertension and left ventricular (LV) morphological and functional parameters resp. which were assessed by echocardiography (ECHOCR). The authors investigated the systolic pressure (BPs) and diastolic pressure (BPd) on admission and the following ECHOCR parameters: weight of the left ventricle, tension of the LV wall during end systole, maximum tension of the LV wall, fractionated shortening of the Lv wall and the relative width...
[Changes in hypertrophy and diastolic left ventricular function during hypertension therapy].
L Elbl, V Chaloupka, R Soucek, J Zák
Vnitr Lek 1992, 38(6):548-554
The authors examined a group of hitherto not treated patients with primary hypertension and hypertrophy of the left ventricle. By means of echocardiography and isometric loading they investigated the effect of treatment on the left ventricular morphology and function. Despite long-term normalization of casual and loading values of the blood pressure the authors did not observe a significant regression of LV hypertrophy. The authors did not find a relationship between the casual blood pressure and weight of the left ventricle with exception of the diastolic pressure after a load. The indicators of diastolic function did not correlate with the weight...
[Late ventricular potentials--relation to the results of programmed ventricular stimulation, the incidence of ventricular ectopic arrhythmias and left ventricular function].
M Pleskot, P Tilser, V Pidrman, M Plic, M Pospísil, D Cernohorský, A Strasová
Vnitr Lek 1992, 38(6):555-561
The authors evaluated the incidence of late ventricular potentials (LVP) in 84 patients (63 men and 21 women) with programmed stimulation of the ventricles. At the same time they described the relationship of the mentioned potentials to the finding of ventricular ectopic arrhythmias during ECG monitoring and left ventricular function (ultrasonographic examination). Non-invasive recording of late ventricular potentials is due to the assessed sensitivity, i.e. 73%, and specificity i.e. 67% (in relation to the results of programmed ventricular stimulation) a useful method for evaluation of the arrhythmogenic substrate of the heart muscle. The authors...
[Uric acid and sinoatrial node function].
J Pella, B Stancák, J Bodnár, J Sedlák, Z Schroner
Vnitr Lek 1992, 38(6):562-565
In a retrospective investigation comprising 54 patients the authors assessed the relationship between the function of the sinoatrial node and raised serum uric acid levels. The function of the sinoatrial node was expressed by the maximal value of the corrected recovery time of the sinoatrial node. No statistically significant correlation was found.
[Chronopharmacokinetics of digoxin in compensated cardiac patients].
J Kopecká, I Janků, V Pidrman, J Martínková
Vnitr Lek 1992, 38(6):566-572
The authors provided evidence that the pharmacokinetics of digoxin are influenced by daily rhythms. Using doses of 0.125 mg digoxin by the oral route, after 12 hours they found a statistically higher serum digoxin concentration in the minimum before administration of the morning dose and in the maximum concentration after this dose, as compared with the minimal and maximal concentration before and after administration of the same dose in the evening. The other pharmacokinetic parameters--the area beneath the curve of serum concentrations, the time before the maximum concentration was attained and the total plasma clearance of digoxin did not differ....
[Diagnosis and therapy of post-infarction cardiac complications].
A Záková, M Precechtělová, L Prokopová, R Soucek
Vnitr Lek 1992, 38(6):573-577
The authors discuss the diagnosis and treatment of acute myocardial infarct complications. They describe a rare combination of these complications: interventricular septum rupture and left ventricular aneurysm with envelope perforation, filled by a thrombus.
[New views on the pathophysiology of the nephrotic syndrome].
M Sasinka, L Podracká, R Roland, J Filka
Vnitr Lek 1992, 38(6):578-588
The authors draw attention to new pathophysiological aspects of some symptoms of the nephrotic syndrome (NS), in particular proteinuria, hypoalbuminaemia and oedema. In proteinuria they focus attention on the formation of a new population of heteropores in severe morphological forms of NS with penetration of high molecular proteins into urine. In hypoalbuminaemia the authors emphasize the importance of an inadequately increased albumin synthesis in the liver. In case of oedema in the majority of patients hypovolaemia is not present, as was assumed so far. In the pathogenesis of oedema primary Na retention in the kidneys is important caused by the glomerulonephritic...
[Changing views on mitral valve prolapse].
J Hradec
Vnitr Lek 1992, 38(6):589-597
Views regarding mitral valve prolapse, in particular its diagnosis and prognosis, have undergone great changes in recent years. The typical auscultation finding of a meso-systolic click and/or late systolic murmur is very specific for prolapse but it is not very sensitive. The basic diagnostic method of mitral valve prolapse is echocardiography. The non-realistic high prevalence of echocardiographic findings of prolapse in otherwise healthy subjects led recently to the introduction of stricter echocardiographic diagnostic criteria. The term mitral valve prolapse syndrome describes not confirmed association of anatomical valvular prolapse with non-specific...
[New views on the etiopathogenesis of beta-thalassemia].
V Fábryová
Vnitr Lek 1992, 38(6):598-602
In the submitted paper the author deals with recent findings on damage of erythrocyte membranes and enzymes in beta-thalassemia. The primary disorder in the formation of beta chains leads to the formation of haemichromes and free oxygen radicals which leads to peroxidative damage of the lipid membrane. The thus generated aldehydes damage important thiol groups of enzymes. Haemichromes interfere with the structure of the protein membrane and the cytoskeleton of the cell. There are differences in membrane damage between alpha and beta thalassaemia. Beta-thalassaemia must be conceived as a comprehensive disease of red blood cells not only as a haemoglobinopathy...
[New views on the therapy of beta-thalassemia].
V Fábryová
Vnitr Lek 1992, 38(6):603-607
The author describes the present situation as regards treatment of beta-thalassaemias. Most frequently the classical combination of transfusions and desferrioxamine is used. Other possibilities are total or partial splenectomy, as well as transplantation of the bone marrow. The mentions also perspective causal therapy by genetic engineering. Systematic and planned prevention still remains most successful.
[A minimal model of insulin and glucose kinetics].
M Kvapil, P Stolba
Vnitr Lek 1992, 38(6):608-616
The minimal model of insulin and blood sugar kinetics is a method the basis of which are two mathematical models describing the dynamic changes of plasma glucose and insulin concentration along with the beta-cell response to the rise of the blood sugar level during the intravenous glucose tolerance test with frequent collection of samples. By means of computer processing the following indices are evaluated: SI--insulin sensitivity, SG--efficacy of glucose, phi 1 and phi 2 describing the sensitivity of beta-cells for glucose. According to present knowledge it is a simple method with a satisfactory reproducibility and validity of assembled results, which...