Vnitřní lékařství, 1992 (vol. 38), issue 9
[A new agent--nitric oxide].
V Schreiber
Vnitr Lek 1992, 38(9):833-836
A review of findings pertaining to EDRF (endothelium derived relaxation factor) which proved to be nitric oxide, NO. After an account of the vasodilatating action of NO in the cardiovascular system the main attention is devoted to macrophages, the source of NO and to the formation of NO during activation of infections and during septic shock. NO participates also in the cytotoxicity of macrophages. NO may be the cause of hypotension in hepatic failure. Cumulation of endogenous inhibitors of NO formation in renal failure may be the cause of hypertension. The author analyzes other clinical effects of NO with regard to impotence and diabetes: NO stimulates...
[Iodine status and incidence of thyropathies in the Czech population].
V Zamrazil, J Bednár, J Cerovská, O Hníková, Z Pôbisová, Z Novák, A Simecková, P Vlcek, M Voborská, J Vrbíková
Vnitr Lek 1992, 38(9):837-844
Based on clinical experience on the rising incidence of some thyropathies in our population, the authors examined a random sample of the Prague population. They assessed and evaluated iodinuria, the sonographic finding of the thyroid gland, the palpation finding of the thyroid and a clinical examination which comprised a detailed case-history (a questionnaire checked during the examination) and a clinical and anthropometric examination. The results indicate that iodinuria (which reflects the iodine intake) reaches the recommended optimum (above 150 micrograms iodine/l) only in 11.4% of boys, 14% men, 6.3% girls and 5.4% women. A quite inadequate intake...
[The importance of optimal iodine intake, the present status and perspectives in Slovakia].
P Langer, M Tajtáková
Vnitr Lek 1992, 38(9):845-849
The concentration of iodine was estimated in 667 urine specimens of boys and girls aged 6-18 years from 5 regions of Slovakia. Only about a half of all values (i.e. 48.43%) was found in the optimum range of 10-20 micrograms/dl, while 40.43% of values wore in the range of iodine deficiency (i.e. less than 10 mu/dl). In addition, there were 10.64% of high values (ie. more than 20 micrograms/dl). These results show that the intake of iodine appears to be 3-4 times higher than before the start of iodine prophylaxis in about 1950, but it still does not reach the optimum level. The increase of iodine intake would be achieved by the replacement of iodide...
[Multiple endocrine neoplasia type 2: familial variant of medullary carcinoma of the thyroid gland].
M Neradilová, M Soutorová, P Vlcek
Vnitr Lek 1992, 38(9):850-859
In addition to a brief characteristic of the syndrome of multiple endocrine neoplasia type 2 and medullary thyroid carcinoma with a familial incidence which is a prerequisite of the syndrome, the authors submit an account on a group of 53 patients who were on the authors' records during the past 12 years. During this period the disease is systematically searched for in the families of newly diagnosed patients by examining the immunoreactive calcitonin level of relatives. Familial variants account for 28% of all medullary thyroid carcinomas. Patients who are on the records so far belong to 24 families. Approximately twice as often an isolated variant...
[The risk for osteoporosis in persons treated with thyroid hormones].
Z Límanová, J Stěpán
Vnitr Lek 1992, 38(9):860-867
Patients taking suppressive doses of thyroid hormones may have adverse effects from such treatment. To test conditions under which such treatment might be deleterious to bone, we studied a group of patients who had undergone thyroidectomy because of thyroid cancer 1 to 21 years previously and were treated with steady suppressive doses of exogenous thyroid hormone. The group consisted from 13 men, 20 premenopausal and 25 postmenopausal women. The level of serum tyroxin a trijodothyronin in average didn't differ from the control subjects; thyreostimulating hormone was significantly lower than in controls. Vertebral bone density (BMD) was significantly...
[Insulin resistance and arterial hypertension. Hyperinsulinism as a basic etiopathogenic factor in essential arterial hypertension and associated phenomena].
J Hrnciar, M Hrnciarová, K Jakubíková, S Korónyi
Vnitr Lek 1992, 38(9):868-878
In 50 normotonic patients with type 2 diabetes (NIDDM) and controls matched for sex and age with NIDDM and hypertension a statistically significant difference was found as regards S-peptide values on fasting, cholesterol, triglycerides, BMI and atherogenic index (cholesterol/HDL, p < 0.01). C-peptide values correlated positively with values of the systolic and median BP and the atherogenic index in both groups. In normotonic diabetics there was also a positive correlation with the BMI and in hypertonic subjects with the triglyceride levels. The results confirm the hypothesis that in NIDDM there is a direct relationship between arterial hypertension,...
[A laboratory test for the detection of androgen resistance using sex hormone-binding globulin].
R Hampl, L Stárka, M Snajderová, M Lachman, B Kalvachová
Vnitr Lek 1992, 38(9):879-886
A simple laboratory test for disclosure of peripheral androgen insensitivity has been suggested. The test is based on determination of sex hormone-binding globulin (SHBG) following single administration of testosterone preparation (Testoviron Depot, Schering, 2 mg/kg of body weight). The kinetics of SHBG response to exogenous testosterone was investigated first in a group of 5 healthy male volunteers. The highest highly significant decrease of SHBG level occurred 7th day after drug administration. The method of choice for SHBG determination is an immunoradiometric assay (IRMA). The test was used for a group of 15 children and young people suspected...
[Thyroid gland antibodies. Methods and clinical significance].
J Bednár
Vnitr Lek 1992, 38(9):887-896
The author presents a brief account of the clinically most important antibodies against thyroid antigens (against thyroglobulin, against the microsomal fraction or thyroid peroxidase, against thyroid hormones and against TSH receptors). He describes the main ways of their assessment in serum and evaluates the practical contribution of their estimation or detection in clinical diagnostic practice concerning endocrinopathies. Usually these estimations are only auxiliary and do not replace functional thyroid tests. Antibodies against thyroglobulin and against the microsomal fraction are found most frequently (and in the highest concentrations) in thyropathies...
[Surgical treatment of endocrine orbital disease. Indications, methods,results].
S Vána, P Rezek, J Lukás, J Dvorák, J Veselý, Z Novák
Vnitr Lek 1992, 38(9):897-902
Surgical removal of the thyroid gland in Graves-Basedow's disease has, beyond doubt, also a major effect on endocrine orbitopathy. After total or near-total removal of the thyroid gland after three months a slighter deterioration or even ameloriation of ocular protrusion is found, contrary to the effect of subtotal thyroidectomy. There exists a significant correlation between the volume of the residual gland evaluated according to 24 h-uptake of 131I, and between the regression of the protrusion (r = 0.385, p < 0.01). Total or near-total thyroidectomy alone even in the absence of other therapeutic methods leads after 1 to 4 years to an average regression...
[Hyperthyroidism in the inappropriate thyrotrophic hormone secretion syndrome].
V Brozková, J Motán
Vnitr Lek 1992, 38(9):903-907
The authors draw attention to the possible presence of hyperthyroidism associated with the syndrome of so-called partial (hypophyseal) resistance to thyroid hormones in the absence of a pituitary tumour, based on the experience assembled during the follow-up of a 35-year-old female patient. The syndrome is characterized by elevated T4, T3 and also TSH levels. The syndrome of partial resistance to thyroid hormones differs from that of generalized resistance by a non-familial incidence and the presence of mild hyperthyroidism; from a pituitary tumour with overproduction of TSH it differs by a positive TSH response to TRH stimulation and the ratio of...
[New views on the pathogenesis of osteoporosis].
J Blahos
Vnitr Lek 1992, 38(9):908-912
The author points out new aspects on pathogenetic factors of osteoporosis and its complications. the character of these factors shows that osteoporosis may be considered as a "civilization disease". The incidence of osteoporosis in all civilized countries is increasing and there is a striking resemblance of factors involved in the pathogenesis of osteoporosis to factors involved in the pathogenesis of other "typical civilization diseases" as are cardiovascular diseases or cancer. In more detail are mentioned the roles of physical exercise, nutrition, drugs and various toxic factors.
[The significance of ovarian and testicular steroids in lipid metabolism and atherogenesis].
J Marek
Vnitr Lek 1992, 38(9):913-920
Epidemiological, experimental and clinical data verify that the risk of atherosclerotic cardiovascular disease is increased by a long-term estrogen deficiency. This is, among other beneficial effects of estrogens on arteries, caused by alteration of lipid and lipoprotein metabolism [e.g. decrease in total cholesterol, LDL-cholesterol and lipoprotein (a) and decrease in HDL2 cholesterol in serum and decrease in the accumulation of cholesterol in the arterial wall]. The beneficial cardioprotective effects of estrogens are attenuated by estrogen overdosing (causing hypertriglyceridemia), the use of synthetic instead of natural estrogen products (increased...
[The favorable effect of hydrolytic enzymes in the treatment of immunocytomas and plasmacytomas].
A Sakalová, M Mikulecký, D Holománová, D Langner, K Ransberger, G Stauder, M Mistrík, S Gazová, I Chabronová, M Benzová
Vnitr Lek 1992, 38(9):921-929
At present attention is focused on research of biomodulating influences on tumorous processes, in particular inhibition of metastatic spread of tumors. In the aetiopathogenesis an important part is played by immune complexes, interaction of cytokines. The authors tested the supporting effect of hydrolytic enzymes in plasmocytoma and immunocytoma. The enzymes were administered along with cytostatic preparations according to the MOCCA pattern. They recorded a more rapid onset and longer persistence of remissions, a marked decline of total proteins, paraproteins, beta-2-microglobulin. Complications associated with paraprotein (hyperviscosity syndrome,...