[Two faces of medicine today].

P Lukl

Vnitr Lek 1994, 40(8):479-481

[The effect of amidepine on induction of ventricular tachycardia using programmed ventricular stimulation].

P Heinc, J Lukl, C Cíhalík

Vnitr Lek 1994, 40(8):482-484

The authors investigated the electrophysiological and antiarrhythmic properties of a new preparation from the group of antiarrhythmic drugs-Amidepine-developed in the Research Institute for Pharmacy. Repeatedly 10 patients with persistent ventricular tachycardia (PVT) which could be induced by programmed stimulation of the ventricles were examined. Nine of them had confirmed spontaneous PVT and one had a syncope of obscure etiology. After i.v. administration of Amidepine no change was observed in the length of the effective refractory period. The induction of PVT was practically affected by Amidepine and conversely the frequency of PVT after Amidepine...

[Results of thrombolytic therapy of acute myocardial infarct-- echocardiographic findings].

P Brunclík, E Augustín, D Baraniková, V Bugán, B Renker

Vnitr Lek 1994, 40(8):485-489

The authors present an account on their experience with echocardiographic examinations of patients with acute myocardial infarction. They evaluated impaired contractility, the left ventricular ejection fraction and compared the results in patients treated by thrombolysis and anticoagulants during the acute stage of myocardial infarction and results assembled one year after development of the acute infarction. The results are significantly more favourable in patients treated by thrombolysis as regards the extent of the infarction, serious contractility disorders, regional contractility and left ventricular systolic function.

[Etiopathogenesis of insudative vasculopathy in transplanted kidneys].

J Jirka, I Reneltová, J Skibová, P Rossmann, M Chadimová, I Matl

Vnitr Lek 1994, 40(8):490-494

In 99 renal allograft recipients with insudative vasculopathy of graft, mean serum cholesterol levels, prevalence of subjects with hypercholesterolaemia, mean cumulative doses of methylprednisolone, prevalence of subjects with methylprednisolone doses > or = 6,000 mg and prevalence of patients with hypertension, all in the period between transplantation and the first diagnostic biopsy, were compared between 51 those with conventional and 48 with cyclosporine maintenance immunosuppression. In subjects treated with cyclosporine the lesion was found in biopsies performed sooner and was present more frequently, prevalence of hypercholesterolaemia and...

[Liver cirrhosis mortality at the Outpatient Clinic in District 8 in Prague 1985-1993].

J Stránský

Vnitr Lek 1994, 40(8):495-498

In 1985-1993 in the out-patient clinic in Prague 8 a total of 59 patients died from cirrhosis of the liver, incl. 30 who were for prolonged periods HBsAg positive and 29 who were HBsAg negative. In the group of cirrhotics with positive HBsAg who died 19 of 29 (66%) were also HBeAg positive which suggested advanced HBV replication during the period of reconstruction of the liver. 43% of those who died and had HBV infection, had glucocorticoid treatment. Only one female patient of 13 had positive anti-HD in serum. In HBsAg negative cirrhotics the main cause of development of cirrhosis was ingestion of alcohol, but at that time it was not possible to...

[The importance of doppler echocardiography in type I diabetics].

J Chlumský, L Dvoráková

Vnitr Lek 1994, 40(8):499-501

Impaired flow through the mitral orifice in diastole is frequently encountered in patients with IHD, hypertension, cardiomyopathies and type II diabetes. The authors examined 40 type I diabetics, age 26 +/- 5.5 years, with a duration of diabetes of 15.8 +/- 7.5 years. The control group was formed by 40 non-diabetic patients comparable as to age and sex. 7.5 years. The control group was formed by 40 non-diabetic patients comparable as to age and sex. During Doppler echocardiography the ratio of early and late peak flow velocity through the mitral orifice (A/E) was evaluated and the time of isovolumic relaxation of the left ventricle (IVRT). The investigated...

[Clinical importance of the paraprotein index in multiple myeloma].

T Papajík, J Bacovský, J Zadrazil, M Budíková, L Faltýnek, V Scudla

Vnitr Lek 1994, 40(8):502-505

In a group of 54 patients with multiple myeloma, hitherto not treated by chemotherapy, the paraprotein index was assessed. It was revealed that this simple and readily available indicator is related to the degree of anaemia, the serum beta-2-microglobulin value, the degree of bone marrow infiltration by myeloma plasmocytes and the survival period. The authors found no relation to age, albumin, urea, creatinine, serum calcium values and degree of skeletal affection. It was revealed that values of the paraprotein index declined with the advancing disease evaluated according to Durie-Salmon's system. It may be said that the paraprotein index can be considered...

[Lower cardiotoxicity of adriamycin during continuous administration in patients with refractory multiple myeloma treated with cyclophosphamide, vincristine, adriamycin and dexamethasone (C-VAD)].

Z Adam, L Elbl, J Vorlícek, R Hájek, M Tomíska, N Hejlová, E Králová, H Novotná

Vnitr Lek 1994, 40(8):506-512

Standard treatment of refractory myeloma is combined VAD treatment (vincristine, adriamycin and dexamethasone). In recent years adriamycin was sometimes replaced by mitoxanthrone which caused greater myelotoxicity. As a positive feature of the exchange of adriamycin for mitoxanthrone, authors using it, report its lower cardiotoxicity. In the literature there are, however, occasional reports on a lower cardiotoxicity of adriamycin when administered in a continuous infusion. In the submitted work the authors sought answers to two questions. 1. Is the cardiotoxicity of adriamycin administered in a continuous infusion lower than the cardiotoxicity of adriamycin...

[Multiple diverticula of the jejunum as a cause of recurrent sub-ileus conditions].

Z Antos, A Tietz, O Bělohlávek, M Vasícek

Vnitr Lek 1994, 40(8):513-516

The authors describe the case of a 72-year-old man who suffered from marked digestive complaints for almost 50 years. They depended on the amount of food and the composition of the diet and during the last six years they led to attacks of severe epigastrial pain and backache associated with subileous conditions. Only enteroclysis led to a diagnostic solution. It revealed a parapapillary diverticulum of the duodenum and multiple diverticulosis of the upper jejunum. CT and scintigraphy, using autologous leucocytes labelled with 99mTc indicated the possible diverticulitis. Simple dietetic and therapeutic provisions eliminated completely the painful attacks...

[The cytokine network in multiple myeloma].

J Bacovský, V Scudla

Vnitr Lek 1994, 40(8):517-520

The authors review contemporary findings on the role of different components of the cytokine network from the aspect of development, prognosis and treatment of multiple myeloma. Greatest attention was devoted to the main growth factor of myeloma elements IL-6, but also to the real or so far sparsely elucidated role of other cytokines (IL-1, IL-2, GM-CSF, G-CSF, IL-3, IL-4, IL-5, IL-10, TNF, interferon alpha and gamma) under conditions in vitro and in vivo. For completeness sake the authors did not omit the problem of the soluble receptor of IL-2 and the role of TNF, TNF beta and in particular IL-1 beta in the pathogenesis of osteolytic lesions and...

[New therapy for osteoporosis].

J Kocián

Vnitr Lek 1994, 40(8):521-525

The author reviews contemporary drugs and procedures used in the treatment of osteoporosis. Long time known substances such as calcium, vitamin D and fluorides are enlarged by the use of thyrocalcitonin, combined treatment with oestrogens and gestagens in post-climacteric women, biphosphonates, and an essential prerequisite remains burdening of the bones by exercise. As to new preparations, the most promising ones seem to be Ipriflavone and TGF-beta; the use of anabolics is tested again, as well as small doses of parathormone and tamoxifen. In the conclusion the author emphasizes the comprehensive character and prolonged period of treatment of osteoporosis...

[Therapeutic strategy in colorectal carcinoma].

P Coupek, I Hánová, Z Pacovský

Vnitr Lek 1994, 40(8):526-529

The authors review the contemporary optimal approach in the treatment of colorectal carcinoma. They emphasize the necessity of a comprehensive therapeutic approach, i.e. a combination of surgery, radiotherapy and chemotherapy in the treatment of colorectal carcinoma. Possibilities of curative and palliative treatment are presented.

[Sepsis. 1].

J Mayer

Vnitr Lek 1994, 40(8):530-532

In the first part of the paper the author pays attention to new findings pertaining to the definition, clinical picture and pathophysiology of sepsis and septic shock. Facts with an immediate impact on clinical practice and therapy are specially emphasized.

[Present and future possibilities in the use of calcium antagonists in the therapy of cardiovascular diseases with special emphasis on amlodipine].

H Purcell

Vnitr Lek 1994, 40(8):545-50