Vnitřní lékařství, 1997 (vol. 43), issue 10
[Favorable effect of splenectomy on anemia in 3 siblings with type II congenital dyserythropoietic anemia (HEMPAS). (Ultrastructural changes in erythrocytes after splenectomy)].
L Chrobák, J Spacek
Vnitr Lek 1997, 43(10):635-638
Congenital dyserythropoietic anemia type II (CDA-type II) (HEMPAS) was reported in three siblings. CDA-type II was associated with marked hepatosplenomegaly and siderosis of both organs. All three sibling developed cholelithiasis with choledocholithiasis and obstructive jaundice in two of them. Anemia showing hemolytic component with sequestration of erythrocytes in the spleen was corrected after splenectomy without the need of blood transfusions during the follow up period of 20, 11 and 11 years. Ultrastructural investigation of the erythrocytes after splenectomy revealed increased number of erythrocytes showing the double membrane phenomenon.
[The autoantibody profile and disease activity in patients with systemic lupus erythematosus].
P Horák, Z Hermanová, L Faltýnek, Z Pospísil, V Scudla
Vnitr Lek 1997, 43(10):639-644
Antinuclear antibodies are a group of autoantibodies which are typical for collagenous diseases. By means of the autoantibody profile different sub-groups of systemic lupus erythematosus (SLE) can be identified. This can serve as a certain prognostic factor of the affection. Patients with a negative antibody profile have fewer clinical and laboratory manifestations of SLE. Profile A (anti-dsDNA and/or anti-Sm has, as compared with patients with a negative antibody profile, more frequent organ manifestations. Patients with profile B (anti-RNP) have a higher frequency of Raynaud's phenomenon. Profile C (anti-Ro, anti-La) is characterized in particular...
[Antithrombin III in various conditions in internal medicine].
J Malý, M Pecka, V Pidrman, Z Zadák, J Gregor, L Jebavý, M Bláha, O Siroký
Vnitr Lek 1997, 43(10):645-648
In a group of 993 patients with serious medical diseases an important deficiency of antithrombin III was found in patients with hepatic insufficiency, pulmonary embolism and with disseminated intravascular coagulation. Acquired antithrombin III deficiency in these conditions develops when the antithrombin production in the liver is low and also in patients with shock syndrome and disseminated intravascular coagulation. Assessment of antithrombin III is of diagnostic and prognostic value in thrombotic and prethrombotic conditions and its results is decisive for adequate substitution. Adequate AT III substitution without concurrent heparin administration...
[Endogenous erythropoietin in patients on regular dialysis therapy].
J Zadrazil, P Bachleda, J Zahálková
Vnitr Lek 1997, 43(10):649-654
In a group of 66 patients with chronic renal failure having regular dialyzation treatment the serum concentration of endogenous erythropoietin (EPO), haemoglobin levels (Hb), haematocrit (Ht) and serum creatinine (Cr) were assessed. The examined subjects were never treated with recombinant erythropoietin and deficiency of iron, folic acid and vitamin B12 was ruled out. Endogenous EPO was assessed by the authors own RIA method, normal values being 24-42 mU/ml. The mean EPO concentration in the whole group of patients was 37.4 +/- 15.3 mU/ml, whereby 12 patients had an EPO serum concentration higher than the upper range of normal values. Between EPO...
[Renal excretion of sodium in individuals with stabilized renal graft function].
J Stríbrná, O Schück, S Vítko, V Teplan, I Matl, J Skibová, M Stollová
Vnitr Lek 1997, 43(10):655-658
In subjects with a transplanted kidney frequently tubular functions are impaired even when the glomerular filtration is within the normal range. In the present work the authors are dealing in more detail with the problem of tubular sodium reabsorption in the transplanted kidney. The purpose of the investigation was to assess to what extent these changes can be explained as the consequence of adaptational changes due to reduction of the number of nephrons and whether these changes have to be taken into consideration in the differential diagnosis of acute changes of graft function. The glomerular filtration rate (GF) was assessed on the basis of polyfructosan...
[The ergometry stress test in patients with stenosis of the left main coronary artery].
R Panovský, Z Stárek, J Meluzín, L Groch, H Koukalová
Vnitr Lek 1997, 43(10):659-662
In 168 patients with ischaemic heart disease an ergometric loading test on a bicycle ergometer was made before coronarography. A total of 19 patients had on coronarography a finding of significant stenosis of the lumen of the trunk of the left coronary artery--group A. These patients were compared with a control group of 20 patients with confirmed coronary heart disease (narrowing of the diameter of the lumen by 50 or more percent) without affection of the trunk of the left coronary artery-group B. As to the investigated parameters of the ergometric test the two groups differed significantly in the total time of the load (group A: 6.21 minutes, group...
[Accessory atrioventricular pathways with decremental conduction (Mahaim connections). 2 case reports].
M Fiala, P Heinc, J Lukl
Vnitr Lek 1997, 43(10):663-671
The so called Mahaim connections form a relatively scarce variant of the preexcitation syndrome. Antidromic atrioventricular reentry tachycardia with wide QRS complex of LBBB morphology represents a typical clinical manifestation of the condition. Nodofascicular and nodoventricular fibres in all the probability do exist, but only rarely. Most of these accessory pathways are located on the firht free wall and conduct only antegradely and decrementally. Majority of these pathways are formed by long bundles inserting in the terminal part of the right bundle branch or in the myocardium near the right ventricular apex. In this setting traditional mapping...
[Retrograde intravenous perfusion--a therapeutic method in trophic defects of the lower extremities. Experience in patients with primary thrombocythemia].
S Jirát, F Staněk, A Jonásová, J Krivánek, D Tesar
Vnitr Lek 1997, 43(10):672-677
Retrograde intravenous perfusion (RIP), so-called Bier's blockade is a relatively new method of treatment of critical ischaemia of the extremities. It is based on the principle of retrograde, i.e. transvenous perfusion of the capillary circulation during which at the time of artificially discontinued circulation in the extremities a high concentration of effective substances in the target tissues is achieved. In addition to the mentioned critical ischaemia Bier's blockade can be successfully used in the treatment of so-called "diabetic foot". It is also possible to implement by this method a local medicamentously induced block of the sympathetic nerves...
[Detection of the Ki-ras mutation as a specific and sensitive marker of pancreatic carcinoma].
T Krechler, J Janda, V Dufek, M Kaláb, M Pesková, V Dorazilová
Vnitr Lek 1997, 43(10):678-681
The authors describe the procedure used for assessment of a Ki-ras mutation as a specific and sensitive marker of carcinoma of the pancreas. The reliability of the method was tested in five patients with carcinoma of the pancreas.
[Survival after accidental poisoning with a triple lethal dose of paraquat (Gramoxon)].
O Cermák, R Brůha, V Danzig, J Petrtýl, Z Marecek
Vnitr Lek 1997, 43(10):682-685
A case of a 22-year old man who accidentally poisoned himself with a triple lethal dose of organophosphate paraquat (commercially produced as Gramoxon). Owing to the quantity consumed and belated medical treatment, toxicologists initially considered the condition incurable but a complex therapy during a 52-day hospitalization eventually saved the patients's life. Following is an analysis of the case a treatment survey and a discussion of mechanisms that possibly led to the successful result.
[Amanita poisoning and the importance of sorption hemoperfusion in its therapy].
V Monhart
Vnitr Lek 1997, 43(10):686-690
Intoxications with poisonous mushrooms, in particular toadstools, are still a serious medical problem. The author presents contemporary views on the etiopathogenesis of intoxications with Amanita phalloides, the clinical picture of the phalloid syndrome and its prognosis. He emphasizes the importance of a comprehensive therapeutic approach, incl. the administration of antidotes (penicillin G and silibinin) and extracorporeal haemoelimination treatment. Early sorption haemoperfusion, either alone or combined with haemodialysis or plasmapheresis, prevent the development of hepatic and renal failure and significantly reduce the mortality from mushroom...
[Fibrillary glomerulopathy].
A Kovác, I Slugen, D Danis, M Demes, M Kollárová, R Kohn, J Podoba, E Goncalvesová
Vnitr Lek 1997, 43(10):691-695
The authors present an account on contemporary knowledge of the diagnosis and differential diagnosis of fibrillar glomerulopathies. The latter are characterized by extracellular localized microfibrils and microtubules resp. in the glomeruli of the kidneys, their diameter being 8-60 nm. They are divided into amyloid and non-amyloid types. The others are classified according to the immunofluorescent finding into immunoglobulin positive and negative ones. The differential diagnosis is important in particular in immunoglobulin positive ones as they are present in serious diseases such as cryoglobulinaemia, monoclonal gammapathy, systemic lupus erythematosus...
[Bisphosphonates in the treatment of osteoporosis].
Z Fojtík, M Kandusová
Vnitr Lek 1997, 43(10):696-699
Bisphosphonates are chemical substances which are used in medicine for the diagnosis of bone diseases, for the treatment of bone metastases of various tumours and in recent years also for the treatment of osteoporosis, in particular postmenopausal or corticoid induced osteoporosis. The administration of biphosphonates is based on the idea that ideal treatment of an enhanced bone turnover is creation of a greater bone mass by de novo bone formation with concurrent inhibition of bone absorption (possibility of dismantling the remodelling cycle). This idea of the action of biphosphonates is based on the finding that they reduce the absorption activity...