[Determination of urea distribution space on the basis of hemodialysis quantification].

J Erben, O Schück, P Moucka, P Fixa, B Hájková, V Herout, R Stilec, J Zahradník, V Palicka

Vnitr Lek 1993, 39(12):1148, 1151

By using direct dialysis quantification--DDQ--in 124 haemodialyses made in 14 patients the authors assessed the urea output in mmol in the dialyzation fluid collected after every dialysis. The evaluation of total body fluids, which accounts roughly for 60% of the total body weight, was replaced by a calculated distribution space of urea (Vu) according to the Du/Ppre--Ppost formula. This equation was modified with regard to the degree of ultrafiltration and urea formation. The authors found a 5% difference between the values of the modified Vu equation and total body fluids corresponding to 60% of the body weight.

[Primary chronic glomerulonephritis with nephrotic syndrome. Treatment with prednisone and cyclophosphamide].

V Knotková, K Němecek, I E Tarayeva, T N Krasnova

Vnitr Lek 1993, 39(12):1157-1163

The authors present their long standing experience with immunosuppressive treatment of patients with nephrotic syndrome associated with primary chronic membranous, mesangioproliferative and mesangiocapillary glomerulonephritis. Of a total of 127 patients 99 were treated with prednisone and cyclophosphamide and 28 with cyclophosphamide only. Clinical remission developed in 89 patients (70%). Remissions developed independently on morphological findings and initial proteinuria, but more frequently in patients with a still normal glomerular filtration. In combined immunosuppression 77% of the treated patients developed remission, while only 48% treated...

[Non-invasive tests in the diagnosis of sinoatrial node dysfunction].

B Stancák, Z Schroner, J Bodnár, S Misíková, J Pella, M Palinský

Vnitr Lek 1993, 39(12):1164-1170

The authors present a group of 67 patients, mean age 63 +/- 15 years, where they applied on account of suspected dysfunction of the sinoatrial node (SA) the atropine test (AT), 24-hour Holter monitoring and transoesophageal stimulation of the atria (TESP). The objective of the investigation was to test the reliability and yield of the mentioned methods and to investigate more closely the relations of their final indicators. Correlation analysis revealed a positive relationship between the maximal frequency during AT and the mean daily (r = 0.553, p < 0.001) and minimal frequency during Holter monitoring (r = 0.349, p < 0.0025). The recovery periods...

[Hypereosinophilia syndrome].

Z Killinger, J Murín, S Galbavý, J Kasper, J Bulas, K Sabolová

Vnitr Lek 1993, 39(12):1171-1175

The authors of the submitted paper describe the diagnosis, course and treatment of hypereosinophilic syndrome in a 36-year-old female patient with marked affection of the right ventricle: endomyocardial fibrosis with parietal thrombi obliterating the cavity of the right ventricle. The clinical picture was dominated by rapid progression of severe cardiac decompensation with a fatal outcome.

[Helicobacter pylori: new answers to old questions].

O Urban

Vnitr Lek 1993, 39(12):1176-1180

Infection with Helicobacter pylori affects 20-40% of the adult population in advanced countries. A causal relationship between Helicobacter pylori and gastritis type B was proved. There is some indirect conclusive evidence of an aetiological association with peptic gastroduodenal ulceration. Attention is drawn to possible associations with gastric malignities. The author reviews aetiopathogenetic relations between Helicobacter pylori infection and these diseases.

[Calcium and hypertension].

J Chlumský

Vnitr Lek 1993, 39(12):1181-1184

Epidemiological, metabolic and intervention studies provided evidence of the interrelationship of calcium and high blood pressure. Patients with essential hypertension and low renin levels respond by a rise of blood pressure to administration of salt, while the pressure declines after calcium administration. Patients with a high renin activity are less sensitive to salt and calcium. The mentioned findings are probably associated with an impaired calcium transmission through the cellular membrane; the structural background of the phenomenon is not known so far. An important finding is the favourable therapeutic effect of calcium channel blockers in...

[Opportunistic mycotic infections in immunologically weakened patients (occurrence, risk factors, pathogenesis)].

J Háber, P Klener

Vnitr Lek 1993, 39(12):1185-1191

A permanent increase of opportunistic mycotic infections is recorded since the sixties in conjunction with new therapeutic procedures. In the submitted review the authors mention mechanisms leading to the development of systemic mycosis. They mention factors of virulence of fungi and predisposing factors which from the aspect of the macroorganism make the development of fungal infections possible.

[The most common pathogens in opportunistic mycoses and their clinical manifestations].

J Háber, E Kolesková, J Straub, P Klener

Vnitr Lek 1993, 39(12):1192-1198

The most frequent pathogens of opportunistic mycotic infections are Candidae. The clinical manifestation of infection is very varied. With regard to the extent of the affection the following are differentiated: 1. mucocutaneous candidosis, 2. organ affections and 3. disseminated candidosis. The incidence of mycoses caused by Aspergillae, cryptococci, and mucors is of a lower order, these infections are, however, associated with a relatively higher mortality. The authors review briefly different fungi and describe the most important clinical manifestations of infection.

[Initial treatment of multiple myeloma].

Z Adam

Vnitr Lek 1993, 39(12):1199-1204

Melphalan and prednisone are still considered the "gold standard" in the treatment of multiple myeloma. In the submitted paper the authors review randomized studies which evaluate the contribution of polychemotherapy in this disease. Polychemotherapy induces a major number of therapeutic responses and its onset is more rapid. However, as regards the survival period the groups treated by standard therapy and polychemotherapy do not differ significantly.

[Diuretic therapy in the aged].

S Krajcík

Vnitr Lek 1993, 39(12):1205-1209

Diuretics are among the most frequently used drugs in old age. Some 12.8% old people living at home use them. Renal changes caused by old age and disease as well as changes of the cardiovascular apparatus and changes in the composition of the organism associated with old age and regulation of the intake and excretion of electrolytes increase the risk of undesirable effects of diuretic treatment in old people.

[Interferon-alfa in the treatment of myeloproliferative diseases].

Z Adam

Vnitr Lek 1993, 39(12):1210-1218

Interferon alpha (INF alpha) is the drug of choice for patients where the interval between the diagnosis and INF alpha administration is not longer than one year. The usual dosage is 5 x 10(6) i.u./m2 INF-alpha s.c. per day. Haematological and cytogenic criteria are applied to evaluate treatment. INF alpha prolongs the life of patients with a cytogenic response. In these patients treatment should be continued till signs of relapse develop. In patients without a cytogenic response INF alpha does not substantially prolong the survival period. INF alpha is indicated in all myeloproliferative diseases associated with thrombocytosis. It holds its place...

[Postgraduate education of future internists].

J Zicha

Vnitr Lek 1993, 39(12):1219-1220

[An unusual cause of a recurrent septic state].

J Sochman

Vnitr Lek 1993, 39(12):1221