[Renal clearance of hippurate in persons with chronic renal insufficiency].

O Schück, V Spustová, R Dzúrik, V Teplan, H Nádvorníková, J Skibová

Vnitr Lek 1994, 40(7):407-410

In 8 subjects with chronic renal failure treated conservatively the renal hippurate clearance (CHip), polyfructosan (CPF) and creatinine (Ccr) clearance was assessed. The mean values of the investigated variables were as follows: CHip = 1.06 +/- 0.79 ml/s, CPF = 0.15 +/- 0.08 ml/s, Ccr = 0.27 +/- 0.17 ml/s. The ratios between the investigated clearance values were: CHip/CPF = 6.9 +/- 4.2 and CHip/Ccr = 4.2 +/- 1.4. The ratio of CHip/CPF was in some instances as high as 10 or more. Between values of CHip/CPF and the plasma hippurate concentration (PHip) a significant negative (non-linear correlation was found (p < 0.01). When the PHip values were...

[The effect of work load on amino acid metabolism].

E Kuhn

Vnitr Lek 1994, 40(7):411-415

The results of a comprehensive investigation of the effect of a 20-minute submaximal (Z1) and exhausting (Z2) work load in a group of 8 healthy volunteers on the amino acid and nitrogen metabolism indicate that, as compared with the mild and significant increase of alanine and drop of leucine (all P < 0.05) during the minor load, after an exhausting load a significant rise and concurrent drop of isoleucine, threonine, ornithine, leucine, serine, glycine, asparagine and glutamine (P < 0.01) occurs and a slightly significant drop of methionine and citrulline, while the total amino acid level is practically unaltered. The rise of alanine suggests...

[The central registry of bone marrow donors and the program for bone marrow transplantation from unrelated donors--20 months' experience].

V Koza, A Bártová, R Herynková, M Svojgrová, H Pittrová

Vnitr Lek 1994, 40(7):416-419

The authors describe their 20 months' experience with the establishment of a bone marrow register in the Czech Republic and its practical association with the programme of bone marrow transplantations from non-related subjects. During the 20 months of activity 5455 voluntary bone marrow donors were examined and at present more than 500 new voluntary donors are examined every month. For 21 patients a HLA identical unrelated donor is sought. For four patients a HLA compatible donor was found. The first bone marrow transplantation from a unrelated donor was performed and another patient is prepared for transplantation within the next few days. The authors...

[Continuous ambulatory peritoneal dialysis--an effective method of treatment in chronic renal failure].

S Opatrná, J Valenta, F Sefrna, K Opatrný

Vnitr Lek 1994, 40(7):420-424

The authors evaluate the results of treatment of continuous ambulatory peritoneal dialysis (CAPD) in seven patient with chronic renal failure during a 12-month period. The baseline examination was made one month before CAPD was started, one day before insertion of a Tenckhoff catheter and then after 1, 3, 6 and 12 months of treatment. The highest assessed mean serum urea concentrations during treatment were 19.8 +/- 2.3 mmol/l (arithmetic mean +/- SE of the mean), creatinine 815.1 +/- 43.1 mmol/l. The haematocrit improved significantly due to CAPD. From the mean value of 22.5 +/- 1.7% recorded one month before treatment it increased to 32.8 +/- 2.5%...

[Comparison of the effect of continuous and intermittent physical loading in type I diabetics].

Z Rusavý, S Lacigová, T Holecek, V Srámek, I Novák, P Těsínský

Vnitr Lek 1994, 40(7):425-428

In order to evaluate the optimal mode of physical loads the authors examined 19 diabetics type I without secondary complications. On the second day of an educational-rehabilitation camp the authors subjected the patients to a continuous load-a 40-minute endurance run at a heart rate equal to 60% of the maximal oxygen requirement. On the fifth day an intermittent load with a maximal intensity--training of 4 x 10 minutes with 5-minute intervals was administered. At the onset, during the 20th and 40th minute of the load the titrable acidity, lactate and blood sugar level were assessed. The intermittent load led already after 20 minutes to marked acidosis...

[Does reconditioning improve compensation in diabetics?].

S Lacigová, Z Rusavý, T Holecek, V Srámek, I Novák, P Těsínský, D Steinhäuselová

Vnitr Lek 1994, 40(7):429-432

The authors evaluate the short-term and long-term effect of a ten-day educational camp on metabolic compensation, the physical and mental state and knowledge of the disease in 30 diabetics type I, mean age 29 years (range 17-45 years) with a duration of diabetes of 6.3 years (plus minus 5.6). After processing of individual parameters at the onset, after termination of reconditioning and after two subsequent months the authors revealed after evaluation by the paired t-test a statistically insignificant drop of the mean blood sugar level after reconditioning. After two months the mean blood sugar level rose again insignificantly and an insignificant...

[Successful control of hypoglycemia through education].

S Lacigová, Z Rusavý, V Srámek, J Tomsů, I Novák, P Těsínský

Vnitr Lek 1994, 40(7):433-436

The objective of the work was to assess whether education focused on hypoglycaemic complications can influence in a favorable way the number of these acute episodes in diabetics type I treated by an intensified insulin regime. Using a questionnaire method, the authors examined 40 diabetics type I without chronic complications, treated by an intensified insulin regime. The authors investigated the most frequent cause, clinical severity and number of hypoglycaemic episodes three months before and three months after a 10-day educational camp. During the three months before reconditioning in the group as a whole total of 600 hypoglycaemic episodes were...

[Evaluation of the nutritional status during treatment of anemia using erythropoietin in patients on regular dialysis therapy].

J Eiselt, E Veselá, J Racek

Vnitr Lek 1994, 40(7):437-439

Treatment of anaemia with human recombinant erythropoietin (r-Hu EPO) substantially improves the quality of life of patients receiving regular dialysis treatment. The positive effect on the nutritional state of patients during r-Hu EPO treatment is not accepted unequivocally so far. The authors followed-up 9 patients (6 men and 3 women) who had regular dialysis treatment, and suffered from severe anaemia. The patients were treated for 12 months with r-Hu EPO (preparation Eprex Cilagd Co.) with an initial dose of 30 mu/kg 3x per week by s.c. route with a target haemoglobin (Hb) value of 90-100 g/l. Before treatment during the 6th and 12th month of treatment...

[Determination of pulmonary hypertension using echocardiography in clinical practice].

J Hůla

Vnitr Lek 1994, 40(7):440-444

In 1992 the author assessed in 130 patients the acceleration time by means of spectral analysis of the Doppler signal in the effluent tract of the right ventricle. In 12 patients this value was compared with direct assessment of the median pressure in the pulmonary artery during catheterization of the heart. The author revealed a relatively satisfactory correlation between these two methods and presents his own regression equation: median pressure in the pulmonary artery (mm Hg) = 73.296--0.426 acceleration time (msec), correlation coefficient--0.86. This equation can be used in practice. The above mentioned examination must be properly performed,...

[Zinc deficiency as a cause of dermatosis in a patient with type I diabetes and renal insufficiency].

M Bouda, M Krízek, I Malkusová, J Motán, K Pizinger, Z Rusavý

Vnitr Lek 1994, 40(7):445-447

[A new therapeutic approach in trophic defects of the lower extremities].

M Emmerová, R Barcal, M Hadravský, M Krátký, J Růzicka, J Větrovcová, I Krausová, V Bursa, T Kydlícek, Z Danda

Vnitr Lek 1994, 40(7):448-450

The authors describe the case of a 60-year-old woman patient with a crural ulcer with a traumatic, arterial, venous and lymphatic aetiology. After three-year unsuccessful treatment by conventional methods and surgery a combination of hyperbaric oxygen therapy and plastic surgery was used. This rational therapeutic approach was very effective and the authors recommend its introduction into routine practice.

[Perspectives in ultrasonic examinations in cardiology].

J Hůla

Vnitr Lek 1994, 40(7):451-454

Cardiac ultrasound is a perspective and mostly non-invasive examination method, which has theoretical and practical prerequisites of wider use. The unexpected rapid progress of the echo-cardiographic technique will continue and penetrate into all spheres of diagnosis of the cardiovascular system. The prerequisite is ever improving equipment, incl. basic instruments, transducers and the standard of echocardiologists. Only then it will be possible to improve by echocardiography the present diagnostic and therapeutic procedures in cardiovascular medicine for the benefit of all specialists engaged in prevention, diagnosis and treatment of cardiovascular...

[Evaluation of the electrocardiogram in indications for thrombolytic therapy in acute myocardial infarction].

L Kuchárová, S Cagán

Vnitr Lek 1994, 40(7):455-459

Authors presented basic criteria for indication of thrombolytic therapy in patients with acute myocardial infarction according literature data and their own experiences from the view-point of judgement of changes on initial standard electrocardiogram (without any changes after administration of nitroglycerin). They are: 1. ST segment elevation > 0.1 mV in at least two contiguous leads, 2. new or presumably new bundle branch block, 3. ST segment depression in thoracic leads V1-V3 in the presumptive presence of acute posterior myocardial infarction. It is valuable to repeat recording, to perform echocardiography (angiography) and to evaluate in complexity...

[When to begin reperfusion therapy in patients with acute myocardial infarct: in the early phase or whenever?].

J Sochman

Vnitr Lek 1994, 40(7):460-464

As regards reperfusion therapy in patients with acute myocardial infarction, the general belief today is that early recanalization of the infarct-related artery--using either thrombolytic therapy or direct mechanical thrombolysis with angioplasty, and undertaken within 6 hours since the onset of ischaemia--can reduce the extent of necrosis, will reduce both mortality during hospitalization and one-year mortality, and will favourably limit regional expansion of the left ventricle affected by the infarction. Drawbacks include apparent reperfusion injury to the myocardium with possible impact on patients' mortality within the first 24 hours. The importance...

[Contribution to a discussion on the future relations between cardiology and internal medicine].

M Anděl, P Widimský

Vnitr Lek 1994, 40(7):469-472