Vnitřní lékařství, 1993 (vol. 39), issue 7
[Uncommon indications for coronary angioplasty].
J Vojácek, P Krupicka, M Aschermann, F Holm, J Humhal
Vnitr Lek 1993, 39(7):632-644
During the period between March 16, 1989 and October 7, 1992 at the Second Medical Clinic of the First Medical Faculty, Charles University Prague a total of 173 coronary angioplasties were performed. With expanding experience and greater availability of controllable super thin conductors and balloon catheters with a small profile, gradually the indication criteria of coronary angioplasty were extended. In 93.1% of patients simple balloon dilatation of a significant stenosis of the coronary arteries was performed and in 6.9% before dilatation in addition an attempt of recanalization of a chronic occlusion of the coronary artery was made. In 74% of the...
[Visual and quantitative evaluation of coronarography findings in patients with percutaneous transluminal coronary angiography].
M Aschermann, J J Ferguson
Vnitr Lek 1993, 39(7):645-650
To compare the accuracy of visual and quantitative estimation of coronary angiograms we studied 114 coronary artery stenosis in 62 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) before and after dilatation. Before PTCA the visual estimate of the mean percentage of stenosis severity was 77.2% (SD + 10.1%) which was significantly higher than the value, obtained with quantitative angiography -71.8% (SD 8.8%) (p < 0.01). Immediately after PTCA the visual estimate of the mean residual stenosis was 18.3% (SD + 10.4%), which was significantly lower, than value from quantitative angiography -23.3% (SD + 10.6%) (p < 0.01)....
[Stress echocardiography in the selection of patients for coronarography].
T Janota, J Král, J Hradec, G Pallay, M Aschermann
Vnitr Lek 1993, 39(7):651-655
Exercise echocardiography has in recent years become the best non-invasive method for detection of IHD. The authors made an investigation with the objective to test the feasibility of exercise echocardiography, under our technically imperfect but generally available conditions, for the selection of patients for coronarography. In 44 consecutive patients (30 men, 14 women, mean age 50 years) the authors used before planned coronarography exercise echocardiography and 24-hour monitoring of ECG according to Holter with evaluation of ST segments. The results of all three non-invasive methods were compared with the coronarographic findings. The criterium...
[Clinical picture of various types of inferior myocardial infarcts. Clinico-electrocardiographic study].
J Kolár, P Kmonícek, J Humhal, M Psenicka, J Ort
Vnitr Lek 1993, 39(7):656-668
In the submitted study the authors evaluate the relationship of the clinical course in patients with inferior myocardial infarction (AIM) in relation to the electrocardiographic (ECG) finding in standard and dextro-lateral leads. In a group of 96 patients (mean age 65 +/- 10 years, 66 men and 30 women) according to the ECG 38 had an isolated inferior AIM (group 1), 28 had signs of extension of the inferior AIM to the posterior wall of the left ventricle (group 2) and 30 patients in group 3 had an extension of the inferior AIM to the right ventricle, i.e. an infarction of the right ventricle. All three groups differed significantly as regards the extent...
[Occurrence and prognosis of silent ischemia].
J Bultas, P Kmonícek, P Krupicka, M Tomecková, D Karetová, V Danzing, S Simek, F Boudník, O Jerábek, M Aschermann
Vnitr Lek 1993, 39(7):669-675
The authors assessed in a group of 486 asymptomatic middle-aged men (50-60 years) the prevalence of silent myocardial ischaemia. For screening they used the exercise test on a bicycle ergometer and in men with a positive test the presence of silent ischaemia was confirmed by perfusion scintigraphy with thallium-201 or by. The prevalence of silent ischaemia was compared with the incidence of angina angiography, myocardial infarction and sudden deaths in a similar group of 1419 men followed up for 10 years in the same department. In patients with a confirmed diagnosis of silent ischaemia the prognosis was monitored, as well as possible clinical manifestations...
[Risk of development of colorectal carcinoma in patients with ulcerative colitis].
M Jablonská, L Rezníková, M Pesková, A Chlumská, J Roth
Vnitr Lek 1993, 39(7):676-681
In patients with ulcerative colitis of prolonged duration and major extent there is according to the majority of investigations an increased risk of development of colorectal carcinoma; the magnitude of the risk which is of major importance for clinical practice, however, differs according to different authors. The present study comprises 189 patients with ulcerative colitis, 103 men and 86 women, perspectively followed up for a period of 12.5 years (8.0-24.5). In 60 patients the distal form was present, in 68 left-sided colitis and in 61 pancolitis. The patients were monitored systematically--clinically colonoscopically and endoscopically. The intervals...
[The effect of the spectrum fatty acids in plasma lipids on the hypolipidemic effect of fish oils in hyperlipidemic patients].
A Zák, M Zeman, E Tvrzická
Vnitr Lek 1993, 39(7):682-689
The authors administered to a group of 60 patients with primary hyperlipoproteinaemia (HLP) HLP type IIA 9, IIB 16, type IV 35 (fish oil) (Activepa 30TG) rich in eicosapentaenic acid (EPA, 20:5-n-3) and docosahexaenic acid (DHA, 22:6n-3). Administration of fish oil, 10 g per day, for a period of 21 days led to a decline of the total cholesterol by 9.8%, triglycerides (TG) by 39.5% and a rise of HDL-cholesterol (HDL-C) by 12.8%. The concentration of LDL-C, apo B, and apo A-I did not change significantly. The content of individual fatty acids (FA) in phosphatidyl choline (PC) cholesteryl esters (CE) and plasma TG before treatment was used as an independent...
[Paget's disease of bone and treatment with pamidronate].
H Wilczek, J Stĕpán
Vnitr Lek 1993, 39(7):690-698
The authors treated 18 patients with Paget's disease of bone (12 men and 6 women, age 65 +/- 5 years) with pamidronate (bisphosphonate of the second generation). Three patients from this group were treated previously without success with calcitonin or bisphosphonate of the first generation (etidronate) 50% of the patients suffered from the polyostotic form of the disease. In one patient a rare combination of primary hyperparathyroidism with Paget's bone disease was found and in another patient later an osteosarcoma developed in the affected bone. To all patients sodium pamidronate was administered (Aredia, Ciba-Geigy) 30 mg per day by i.v. infusion...
[Albuminuria and N-acetyl-beta-glucosaminidase activity in a prospective study of type I diabetics].
J Skrha, M Sperl, P Stolba, J Hilgertová, V Stibor
Vnitr Lek 1993, 39(7):699-705
The authors investigated a group of 47 type I diabetics in a prospective study extending over 8 years. Every year they evaluated the albuminuria and the N-acetyl-beta-glucosaminidase (NAG) activity in serum and urine and the results were compared with the state of compensation of diabetes and with the clinical finding on the ocular fundus. During the eight-year period newly manifested microalbuminuria developed in 8 of 32 patients (25%) who at the onset had a normal finding. In patients with newly manifested microalbuminuria the authors found a significant rise of the fructosamine serum concentration (p < 0.05) and at the same time a rise of serum...
[Essential mixed cryoglobulinemia and the kidneys].
V Knotková, O Krystůfková
Vnitr Lek 1993, 39(7):706-713
The authors describe their experience with the treatment of nine patients where "essential" mixed cryoglobulinaemia was diagnosed. In addition to extrarenal symptoms all suffered from proliferative glomerulonephritis, most frequently mesangiocapillary. The latter was manifested in most instances during the first examination by nephrotic syndrome and reduced glomerular filtration. Two patients had only asymptomatic proteinuria with erythrocyturia. The majority suffered from arterial hypertension. The patients were treated with prednisone and cyclophosphamide, using initial doses after which the extrarenal symptoms receded promptly. Regression of proteinuria...
[Atypical chronic mesangioproliferative glomerulonephritis].
L Golán, V Knotková, K Němecek
Vnitr Lek 1993, 39(7):714-719
The case report describes the atypical course of a chronic mesangioproliferative glomerulonephritis, which presented with macroscopic haematuria lasting continuously almost 9 years. Proteinuria and macroscopic haematuria ceased after tonsillectomy and a prolonged corticosteroid therapy.
[Current trends in antihypertensive therapy: pro and con].
J Widimský
Vnitr Lek 1993, 39(7):720-725
Treatment of hypertension reduced markedly (by more than 40%) the prevalence of cerebrovascular attacks, the prevalence of cardiac failure, malignant hypertension and ophthalmological complications of hypertension. The impact of antihypertensive treatment on the incidence of ischaemic heart disease is less marked. The wide use of diuretics and beta-blockers is supported by the fact that large studies of antihypertensive treatment revealed that they reduced the cardiovascular mortality and morbidity in a marked way. On the other hand, diuretics exert a negative effect on insulin resistance, glucose tolerance, cholesterol and may lead to hypokalaemia...