[Heart transplantation at the Institute of Clinical and Experimental Medicine in Prague].

D Urbanová, I Málek, M Gebauerová, V Staněk

Vnitr Lek 1994, 40(2):75-78

In the Institute of Clinical and Experimental Medicine in Prague 101 orthotopic allotransplantations of the heart were performed in 100 patients (87 men and 13 women). The reason for transplantation were terminal stages in the first place dilated cardiomyopathies and ischaemic heart disease. 58% of the patients survive after transplantation, the mortality rate is 42%. The highest mortality is in the early postoperative period (within two weeks after operation)--21 cases (50%). The longest survival period is nine years and six months. All patients have cyclosporin immunosuppressive treatment (in combination with another drug, later with another two...

[Lactobacilli in the treatment of dyspepsia due to dysmicrobia of various causes].

J Kocián

Vnitr Lek 1994, 40(2):79-83

In 30 patients with dyspepsia caused by dysbacteriosis of the gastrointestinal tract the authors administered the preparation Lactobacillus acidophilus (Rossel Co. Canada)--1. capsule with 2 billion live bacteria, in the morning after breakfast. The patients were divided into four groups: maldigestion, malabsorption, radiation enterocolitis and administration of antibiotics. The patients recorded themselves their subjective symptoms: pain, pressure, bloating, flatulence and appetite, and as to objective symptoms, the number and consistency of bowel movements, changes of body weight. The most rapid effect was achieved in dysbioses after antibiotics--within...

[Thrombocytes as an indicator of activity in Crohn's disease treated with total parenteral and/or enteral nutrition].

J Bures, J Horácek, M Pecka, M Tichý, B Cervenka, B Král, B Fixa, O Komárková, V Pidrman

Vnitr Lek 1994, 40(2):84-88

UNLABELLED: Inflammatory bowel disease can be associated with increased platelet count. Aim of our study was focused on assessing thrombocyte count in evaluation of the activity in Crohn's disease (CD). The study included a total of 19 patients [6 men, 13 women (aged 18-57 years, mean 33, median 28]. All patients were malnourished in active stage of the disease on total parenteral and/or enteral nutrition (TP/EN). Thrombocytes were estimated at the beginning and after 3 weeks of TP/EN in venous blood sample using automatic analyser Coulter Counter JT3 (normal range: 130-380.10(9)/l). Serum prealbumin, transferrin, haptoglobin, alpha 1-orosomucoid and...

[Vasosan S--a cholestyramine in the treatment of hypercholesterolemia of various etiopathogenesis].

P Kolesár

Vnitr Lek 1994, 40(2):89-92

Cholestyramine was used for the first time in the treatment of hypercholesterolaemia by Tenneton in 1960 and it persist in the treatment to the present time. The authors had the opportunity to monitor under clinical conditions the hypolipidaemic action of cholestyramine - the preparation Vasosan (manufactured by AG Chemie, Germany) in the treatment of hypercholesterolaemia of different origin, and also when associated with hypertriacylglycerolaemia. The authors revealed that Vasosan S reduced significantly total cholesterol, LDL cholesterol and apoprotein B even after brief treatment (12 weeks) even when there is also hypertriacylglycerolaemia. The...

[The effect of compensation in diabetes on left ventricular diastolic filling].

J Chlumský

Vnitr Lek 1994, 40(2):93-95

Examination by Doppler echocardiography in diabetics frequently reveals an impaired diastolic function of the left ventricle. However, it is not known this disorder is influenced by compensation of diabetes. The author examined therefore 10 type 1 diabetics, 20 type 2 diabetics without retinopathy and 10 type 2 diabetics with diabetic retinopathy. He eliminated patients with hypertension, valvular defects and manifest IHD. The groups were compared with controls of comparable age, sex and habit. Echocardiographic examinations were made before, one month after and two months after the onset of intensive insulin therapy. Compensation of diabetes was evaluated...

[HLA-B27w (weak HLA-B27)--another subtype of HLA-B27 antigen].

A Májský

Vnitr Lek 1994, 40(2):96-97

The authors describe another subtype of antigen HLA-B27, described as HLA-B27P3. It was assessed, using 5 anti-HLA-B27 sera. It is identical with the weak antigen HLA-B27(HLA-B27w) described by the author in 1976.

[Long-term survival in multiple myeloma].

A Sakalová, M Mikulecký, L Dedík, M Prümmerová, S Gazová, I Chabronová, M Mistrík, T Lipsic

Vnitr Lek 1994, 40(2):98-103

The authors present the results of 23-year protocol studies of survival with multiple myeloma, focused on problems of perspective long-term survival. Of 535 diagnosed patients between 1970 and 1990 the authors checked regularly and treated 475. In addition to 60 latent forms where treatment was administered only when clinical symptoms developed or after progression of laboratory signs, to all patients treatment was administered according to protocols (monotherapy-cyclophosphamide prednisone in 1970-1975 only to 30 patients, the remainder had combined treatment--COPP, VMCP, MOCCA); in the third stage of the disease MOCCA treatment is better. The median...

[Amyloid light-chain amyloidosis with primary involvement of the cardiorespiratory system--2 case reports].

V Danzig, Z Danzigová, K Lukás, J Ort, M Elleder, V Campr, S Sikulová

Vnitr Lek 1994, 40(2):104-107

The authors describe the cases of two women suffering from AL amyloidosis with affection of the heart muscle in particular. In one of the patients there were also massive amyloid deposits in the lungs which is an exceptional finding. The observations confirm the adverse prognosis of amyloidosis, the rapid progression of the disease after the onset of symptoms of cardiac failure. The first cardial manifestation in both patients were palpitations. The first patient, but not the second one, had a myeloma confirmed on necropsy.

[Restrictive infiltrating cardiomyopathy in primary amyloidosis].

J Mach, M Grézl, J Veselý, P Navrátil

Vnitr Lek 1994, 40(2):108-110

The authors describe a typical echocardiographic finding in restrictive infiltrative cardiomyopathy which after two years led to the diagnosis of primary amyloidosis in a 51-year-old woman. The predominating manifestations of the disease were renal damage with final failure, heart failure, monoclonal gammapathy and damage of other organs. Aimed treatment of amyloidosis and repeated haemodialysis did not prevent the patient's death from cardiac and renal failure. Primary amyloidosis was confirmed by histological examination and necropsy.

[Coronary thrombosis--pathogenic basis of acute coronary syndromes].

J Dúbrava, S Cagán

Vnitr Lek 1994, 40(2):111-117

Acute coronary syndromes (unstable angina pectoris, acute myocardial infarction, sudden heart death) present an important part of cardiovascular and total morbidity and mortality. The common pathogenetic mechanism of them is the break of integrity of "stable" atherosclerotic plaque through fissure or rupture with following dynamic occlusion of coronary artery. In dynamic occlusion take part coronary vasoconstriction and dominant coronary thrombogenesis. Summary review of pathogenesis of coronary thrombosis aimed at origin of "unstable" atherosclerosis plaque, importance of vessel wall factors, rheologic factors and thrombocytes is presented in the...

[A review of new cephalosporin antibiotics].

M Hupková, J Blahová, M Babálová, Krcméry VSr

Vnitr Lek 1994, 40(2):118-121

The authors discuss some properties of recent cephalosporin antibiotics and the antibiotics effectiveness in particular of more recent generations of cephalosporins. The increasing resistance to penicillins and other antibiotics called for use effective cephalosporins of new generations. While cephalosporins of the 1st generation (cephalothin, cephazoline, and oral cephaloridine or cephaclor) are effective against Gram-positive bacteria, haemophilus bacteria and Klebsiellae, the resistance of other bacteria even against these antibiotics is increasing. Mephoxine and cephuroxime belong to the 2nd generation as their spectrum of efficiency is wider....

[Interferon alfa in the treatment of monoclonal gammopathies].

Z Adam

Vnitr Lek 1994, 40(2):122-126

Maintenance treatment with interferon alpha protracts the remission of multiple myeloma and this treatment can therefore be recommended. For combined treatment of newly diagnosed multiple myeloma so far the optimal dose and time schedule is not yet known and therefore combined treatment cannot yet be recommended for standard therapy. Similarly, also in primarily resistant or relapsing disease the indication of interferon alpha is not yet final and interferon alpha is used in this indication only in clinical trials and in common treatment only as the last resort. Interferon alpha holds its place in Waldenström's macroglobulinaemia. Because of the price...

[Adverse effects of interferon alfa].

Z Adam

Vnitr Lek 1994, 40(2):127-129

Interferon treatment means for many patients prolongation of their life. On the other hand, this treatment is associated with many undesirable effects listed below. Symptoms reminding of influenza (fever, articular and muscle pain, fatigue, loss of appetite, gastrointestinal complaints and mild psychic irritability) are frequent. As regards laboratory examinations, interferon alpha treatment is associated with a drop of the number of leucocytes and to a smaller extent also other blood elements and with a rise of liver enzyme levels. Serious and life threatening undesirable effects are fortunately rare. In rare instances cardiovascular complications...

[New findings in the immunologic classification of malignant lymphomas].

K Koubek, J Starý

Vnitr Lek 1994, 40(2):130-139