[Hemocoagulation and hemorheology in heart failure and the possible effects of glycosaminoglycans].

J Spinar, J Novotný, J Mayer, J Vítovec, L Spinarová

Vnitr Lek 1995, 41(1):3-7

Chronic congestive heart failure is one of the risk groups of acquired hypercoagulant and hyperviscous state. In a group of patients with medium and severe cardiac failure the administration of sulodexide led to an increased activation of the fibrinolytic potential--a drop of PAI-1 and fibrinogen, to an increased activation of anticoagulatory potential--an increase of AT III and reduced plasma viscosity. Global coagulation and biochemical screening parameters were not affected by treatment. Administration of the preparation did not exert important undesirable effects and was well tolerated.

[Stress tests in chronic heart failure].

L Spinarová, J Spinar, B Zatloukal, J Vítovec, J Toman, M Stejfa

Vnitr Lek 1995, 41(1):8-12

The authors compared two types of spiroergometric tests in 14 patients with chronic heart failure (NYHA II-III, ejection fraction < 40%). Test A: 0.25 W/kg 3 minutes, 1 minute break, increase by 0.25 W/kg á 3 minutes. Test B: 25 W 2 minutes without break, increase by 10 W á 2 minutes. The two tests did not differ as to the achieved heart rate, blood pressure reading, oxygen consumption and biochemical parameters at the end of the load, even at the level of the anaerobic threshold. There was a significant statistical difference in the duration of the load: test A lasted 16.4 minutes, test B 9.7 minutes (p < 0.001). The length of the test B correlated...

[Structural variants in hemoglobin occurring in the Czech Republic].

K Indrák, V Brabec, V Divoký, H Fortová, J Suttnar, L Chrobák, B Wiedermann, T H Huisman

Vnitr Lek 1995, 41(1):13-20

The authors present a review of clinical and laboratory findings of seven in the Czech Republic hitherto diagnosed structural haemoglobin variants. Unstable variants are found most frequently: Hb-Köln, Hb-St. Louis, Hb-Nottingham, Hb-E and Hb-Hradec Králové. The variant Hb-Hradec Králové (Hb-HK) or alpha 2 beta 2 115 (G17) Ala-Asp was newly detected. The great instability of Hb-HK chains makes classical diagnosis of Hb-pathy impossible. It was possible to identify it only at a molecular genetic level. A manifestation of Hb-HK instability is also the thalassaemic feature of the disease and the formation of Heinz bodies from free chains. The only representative...

[Subcutaneous chamber systems (ports) for long-term care in cancer patients].

R Hájek, P Sevcík, J Ondrásek, J Mayer, I Vásová, Z Král, M Tomíska, E Krahulcová, M Penka, H Kubesová

Vnitr Lek 1995, 41(1):21-27

Maintenance of satisfactory and safe venous access in cancer patients is part of a comprehensive care of cancer patients. As the Hickman/Broviac catheter is today used an implantable port. This port is placed in a subcutaneous pocket. The catheter connected to the port leads into the central vein, usually through the subclavian vein. An application of drugs in the port is done trough the skin. In this time could be used different types of ports, one or two chambers port, low profil port, peripheral port and others. In this paper we reported our two-years experience with 33 totally implantable access systems, which has been implanted in patients with...

[Immunocytochemical phenotyping of centroblastic lymphoma cells].

J Krejsek, O Kopecký, P Zák, K Podzimek

Vnitr Lek 1995, 41(1):28-33

Using immunocytochemical phenotyping, the authors assessed the origin of malignant cells in a patient with malignant centroblastic lymphoma. The lymphoma cells expressed the thymocytic surface molecule CD1, pan T-lymphocytic markers CD2, CD5, CD6, CD7 with concurrent absence of complex CD3 and receptors for antigen on T lymphocytes. The proliferating activity of malignant cells could not be controlled by intensive cytostatic therapy.

[Results of induction therapy in newly diagnosed acute myeloid leukemias in study 911 at the Institute of Hematology and Blood Transfusion].

P Lemez, A Vítek, J Jelínek, M Lukásová, A Palecek, J Sajdová, A Jedlicková, Z Vorlová

Vnitr Lek 1995, 41(1):34-39

Thirty-seven patients with de novo acute myeloid leukemias were admitted to the Institute of Hematology and Blood Transfusion in Prague in February 1991-December 1993. Their age was 18-85 years with a median of 46 years. Two patients died on the day of admission, chemotherapy was initiated in 35 patients. Altogether 27 patients (77%) achieved complete remission (CR), i.e. 18 (81%) of 22 patients younger than 55 years and 9 (70%) of 13 patients older than 55 years. Only 7 (35%) of 20 patients achieved CR after a single therapy course 3/7 consisting of 3 doses of daunorubicin 45 mg/m2 on days 1, 3, 5 and cytosine arabinoside 150-200 mg/m2 every 12 hours...

[Treatment of adult acute lymphatic leukemia with polychemotherapy supported by the leukocyte growth factor G-CSF].

E Krahulcová, M Penka, H Franková, M Pisarcíková

Vnitr Lek 1995, 41(1):40-43

The treatment results in 13 patients with acute lymphatic leukemia are reported. All patients were treated according to the Hoelzer protocol. Granulocyte colony-stimulating factor (G-CSF) was administered till the onset of neutropenia and was continued as long as the leukocyte number increased above 3 x 10(9)/l. In phase I of Hoelzer's protocol G-CSF was administered on the average for 12 days, in phase II for 15 days. The chemotherapy of phase I was administered in scheduled time to 11 patients. In phase II the average delay against the scheduled time was 14 days. Reductions of dose were made only in 2 person. After finishing phase II 9 patients were...

[Colorectal polyps and their endoscopic therapy].

O Urban, J Chalupa

Vnitr Lek 1995, 41(1):44-45

[Biliary-duodenal prosthesis in the palliative treatment of tumors in the subhepatic region].

V Dufek, J Petrtýl, P Klener, Z Marecek, J Spicák, J Chmel

Vnitr Lek 1995, 41(1):46-48

In the group of 347 patients (pts) with biliary cancer (218 females and 129 males, age range 42-88 years), the large size bilio-duodenal endoprostheses (BDE) were inserted. The success rate in BDE implantation varied from 68 to 92% according to the localisation of the common bile duct stenosis and its anatomy. The BDE introduction was followed by step-by-step normalisation in laboratory markers of biliary obstruction in 76% of pts, the full functional capacity of BDE varied from 26 to 311 days (median 168 days). In pts treated by BDE the survival median was 210 days. Early complications did not exceed 2.2%, late complications were observed in 8% out...

[A 2-month period of physical training in insulin-dependent diabetics].

B Krahulec, J Adamka, J Krahulcová, J Vozár

Vnitr Lek 1995, 41(1):49-52

Twenty type 1 diabetics participated after previous individual instructions in a 8-week physical training programme. The latter comprised three training units per week. One training unit started by 10-minute warming up exercise, then the patients pedalled on a bicycle ergometer 2 x 10 minutes with a 5-minute break with a load amounting to 80% of the oxygen consumption during the maximum tolerated load. The final part was formed by swimming in a swimming pool, covering a distance of at least 200 m. After the termination of the programme the authors did not observe significant changes in the carbohydrate and lipid metabolism nor in physical performance,...

[The sleep apnea syndrome in patients with acromegaly].

M Pretl, V Weiss, K Sonka

Vnitr Lek 1995, 41(1):53-55

The authors examined 19 nonselected patients with acromegaly (8 women and 11 men), incl. 16 where the disease was hormonally active, 3 had normal growth hormone values, 11 patients had a surgical operation of the pituitary. The examination was made by the MESAM 4 method (all-night recording of the heart rate, respiratory sounds, body position and arterial oxygen blood saturation). The sleep apnoea syndrome was diagnosed in 10 patients (52.6%). In patients where the sleep apnoea syndrome was not confirmed by MESAM 4, so-called intermittent snoring was found, an indirect sign of impaired ventilation during sleep.

[Cushing's syndrome in pregnancy].

A Kreze, E Spirová, Z Putz, J Danko, J Visnovský, J Breza, M Pauer, B Renker

Vnitr Lek 1995, 41(1):56-60

Active Cushing's syndrome during pregnancy is a rare phenomenon which was so far described in the literature only in 85 women. The authors give an account of a patient who developed Cushing's syndrome during pregnancy and who was delivered during the eighth month of a healthy foetus by caesarean section, afterwards the hypercortisolism associated with hyperaldosteronism was treated by dextrolateral adrenalectomy. In the removed adrenal gland was a cortical adenoma made up of clear cells and cells reminding of the zona glomerulosa. Subsequently the authors summarize data from the literature on the prevalence of different pathogenetic forms of Cushing's...

[Endogenous digoxin-like and ouabain-like substances].

R Kohn, B Lichardus, M Rusnák

Vnitr Lek 1995, 41(1):61-64

Despite the fact that cardioglycosides have been used in the treatment of cardiac failure for more than 2000 years, endogenous digoxin and ouabain-like substances were identified from the chemical aspect only in 1990. They are steroids, their main site of origin being the adrenals. It is assumed that they play a part in the regulation of the body fluids and sodium in the organism and participate in the regulation of cardiac activity. The stimulus which leads to their release into the blood stream are above all conditions associated with sodium and fluid retention with expansion of the intravascular volume. It is assumed that these substances participate...