Vnitřní lékařství, 1995 (vol. 41), issue 11
[Symptomatic and silent myocardial ischemia during drug therapy and after aortocoronary bypass].
J Meluzín, K Zeman, J Cerný, P Simek, J Julínek
Vnitr Lek 1995, 41(11):739-743
In 53 patients with stable angina pectoris 24-hour ambulatory electrocardiographic monitoring (Holter) and bicycle ergometry were used before and six months after a coronary bypass. The examination before operation was made while anti-ischaemic medication was administered, the examination after revascularization was done without medication. The patients were divided into group A (31 patients where complete revascularization of the myocardium was made) and group B (22 patients with incomplete revascularization) and the results were compared during medication and after aortocoronary bypass. In patients of group A revascularization prolonged significantly...
[Spirapril in the therapy of mild and moderately severe hypertension. A Czech and Slovak multicenter study].
J Widimský, V Lánská, V Hulínský
Vnitr Lek 1995, 41(11):744-752
A one-year open study was focused on the therapeutic effect and tolerance of spirapril in 171 patients with mild to moderate hypertension in 11 centres in the Czech and Slovak Republic. The antihypertensive effectiveness was investigated after four weeks, after 12 weeks and after 52 weeks. Only the results recorded after one year are reported. The study was completed after one year by 139 patients, incl. 120 (86.3%) with a normal diastolic pressure of 90 mmHg or less. The study was not completed by 32 patients (18.8%): because treatment was not effective--9.4%, because of undesirable effects--4.7%, 3.5% were eliminated by the investigators for various...
[Determination of dry weight of hemodialyzed patients on the basis of the ratio of extracellular fluid volume to total body fluid volume as measured by multifrequency impedance].
F Lopot, P Kotyk, J Forejt
Vnitr Lek 1995, 41(11):753-758
Whole body impedometry is relatively new non-invasive method to measure the distribution of total body water (TBW) between extra- and intracellular compartment (VEC, VIC). Having applied linear regression analysis onto the relation of the ratio of the extracellular volume to the volume of total body water (VEC/TBW) and the age in a group of healthy individuals very narrow scatter from the regression line was found. This line can thus be used as an indicator of normohydration status with respect to age. Assuming that the relation of VEC/TBW vs. age is the same in dialysed patients and that the state of normohydration corresponds to the so called dry...
[Personal experience with replacement therapy with intravenous gamma globulin].
J Litzman, J Lokaj, D Stikarovská, J Mayer, V Thon, M M Eibl
Vnitr Lek 1995, 41(11):759-763
Replacement therapy with intravenous immunoglobulin (IVIG) is currently the therapy of choice in patients with antibody-formation deficiency. Our 30-month experience with IVIG treatment in 8 patients with common variable immunodeficiency and in 4 patients with x-linked agammaglobulinemia previously treated by intramuscular immunoglobulin or low-dose IVIG is presented. Long-term dosage was 400 mg/kg once in 3--4 weeks. Ten patients reported an improvement of their health state, especially the signs of their chronic bronchitis improved. Compared to 2 cases of pneumonia which occurred within 30 months before IVIG therapy had started, no case of pneumonia...
[Rheumatoid pericarditis: correlation with immunologic parameters].
S Alusík, H Skalická, J Vencovský, M Kohoutová
Vnitr Lek 1995, 41(11):764-766
In 35 patients with rheumatoid pericarditis the laboratory findings were compared with those of a group of 65 patients with rheumatoid arthritis without a pericardial exudate. The authors assessed the red cell sedimentation rate and serum levels of immunoglobulins G, M, A, semiquantitative values of the rheumatoid factor, circulating immunocomplexes, C3 and C4 complement components, the positivity of antinuclear antibodies and values of C-reactive protein. The authors found significantly elevated values of immunoglobulins M in patients with rheumatoid arthritis without a pericardial exudate. As regards the other investigated parameters the two compared...
[Evaluation of treatment of anemia with erythropoietin in patients with multiple myeloma].
Z Adam, M Krahulová, S Spelda, J Vorlícek, N Hejlová, R Hájek, M Tomíska
Vnitr Lek 1995, 41(11):767-772
Multiple myeloma is very frequently associated with anaemia which has the character of hypo-proliferative anaemia of chronic diseases. In this type of anaemia the erythropoietin formation is frequently inadequate. According to data in the literature pharmacological doses of erythropoietin lead to an increase of the haemoglobin concentration in blood. Erythropoietin (Eprex Cilag) was administered to 11 patients whose haemoglobin concentration was lower than 100 g/l. The results from 10 patients were finally evaluated. During the first month all patients were given erythropoietin - 150 U/kg three times per week. Unless during the first month of treatment...
[Hypercirculatory heart failure in a patient with plasmacytic leukemia].
E Goncalvesová, E Uhliariková, A Vahancík, R Kohn, J Gyarfás
Vnitr Lek 1995, 41(11):773-776
High cardiac output failure/state (HCOF) is regular feature of some illnesses e.g. thiamine deficiency, hyperthyroidism, severe anemia, Paget's disease or arteriovenous fistulae. HCOF in multiple myeloma is reported quite rarely. 31-year-old man was admitted because of fatigue, dyspnea and subfebrilities. Heart rate was 116/min, sinus rythm blood pressure 110/60 mmHg. Chest film showed cardiomegaly with sings of interstitial pulmonary edema, echocardiography mild dilatation of the left ventricle with hyperkinetic wall motion and small pericardial effusion. Hemoglobin was 104 g/l, leukocyte count 13.5 x 10(9)/l with 30% of plasmatic cells. Serum protein...
[Subacute thrombosis of the abdominal aorta with suprarenal involvement and successful treatment with pharmacomechanical fibrinolysis].
J Bastecký, A Krajina, P Eliás, J Kvasnicka, A Michl, E Simáková, M Lojík, P Fixa, R Stilec
Vnitr Lek 1995, 41(11):777-782
In a 43-year-old patient with Ebstein's anomaly and a history of acute myocardial infarction by means of duplex ultrasonography and aortography the diagnosis of thrombotic occlusion of the a aorta was established, starting above the insertion of the renal arteries and reaching as far as the bifurcation of the aorta and the common iliac arteries. In the clinical picture dominated complete anuria with uraemia and marked hyperkaliaemia as a result of ischaemic affection of the extremities due to thrombosis of the aorta; at the onset of hospitalization also left ventricular failure with hyperhydration and later also signs of the hyperviscous syndrome....
[Unusual manifestations of dual atrioventricular nodal conduction].
A Mádle
Vnitr Lek 1995, 41(11):783-786
In three case reports the unusual patterns of dual atrioventricular nodal conduction are shown - intermittent complete block in the fast pathway, Wenckebach-type block in the fast pathway, and parallel simultaneous conduction through both the nodal pathways with a double ventricular response. The importance of these phenomena consists at least in the differential diagnostics.
[The importance of measuring pulmonary venous flow using doppler echocardiography].
J Veselka
Vnitr Lek 1995, 41(11):787-791
Pulmonary venous flow can be evaluated by means of pulsed Doppler echocardiography during transthoracic or even better during transoesophageal examination. In the majority a three-peak spectral curve is recorded with the highest positive wave during ventricular systole, a lower positive wave during ventricular diastole and a negative wave during contraction of the left atrium. The author discusses some factors which have an impact on the pulmonary venous flow and which must be taken into account for its correct evaluation. With regard to clinical importance the author emphasizes in particular the change of venous pulmonary flow when the pulmonary pressure...
[The role of echocardiography in the diagnosis of infectious endocarditis].
J Chlumský
Vnitr Lek 1995, 41(11):792-795
Echocardiography is irreplaceable in the diagnosis of infectious endocarditis. If in easily examined patients transthoracic examination suffices, in all other cases transoesophageal echocardiography is essential. It is important to emphasize the importance of searching carefully for complications, of assessment of the patient's risk and whether it is suitable to repeat the examination during treatment.
[Osteoporosis. 1].
Z Fojtík, J Mayer
Vnitr Lek 1995, 41(11):796-801
This article reviews the available data considering the question of pathogenesis and diagnostic of osteoporosis. Low bone mass can occur because there is insufficient bone deposited in the skeleton during growth, modelling, or because bone tissue is subsequently lost, remodelling. Peak bone mass is largely under genetic control, adequate nutrition during growth. Bone loss results from disturbance of bone remodelling, a continuous preventive maintenance programme in the adult skeleton. Bone remodelling is a quantum phenomenon that occurs in discrete units in four phases. Calciotropic hormones modulate the bone-cell production rate of cytokines and growth...