Vnitřní lékařství, 1997 (vol. 43), issue 11
[A single-center controlled clinical study with Sandimmune Neoral after kidney transplantation].
I Matl, S Vítko, J Lácha, M Horcicková, L Nosková, M Símová, P Táborský, O Viklický, V Hulínský, V Lánská
Vnitr Lek 1997, 43(11):703-706
The authors compared in a controlled clinical study two groups of patients after a first renal transplantation treated by triple drug immunosuppressive therapy. In a group of 31 patients the triple combination comprised Sandimmune Neoral. In the control group there were 30 patients who received Sandimmune. No differences were found between the two groups as regards the effectiveness of this treatment and the authors did not confirm a lower incidence of rejections described in patients treated with Sandimmune Neoral. They confirmed, however, a lower interindividual variability of Cy-A levels assessed specifically in patients treated with Sandimmune Neoral.
[The effects of Carvedilol, a beta-blocker, in experimental ischemia-reperfusion kidney injury].
J Necas, L Bartosíková, L Drápelová, K Husek, V Pavlícek, S Kuchtícková
Vnitr Lek 1997, 43(11):707-711
Carvedilol is a recently introduced drug with multiple action with a non-selective beta-antiadrenergic and selective alpha1-antiadrenergic action used for treatment of mild to medium severe hypertension. The authors investigated in their experiments the protective effect of carvedilol under conditions of ischaemia-reperfusion of the kidney in the laboratory rat. The animals were divided into four groups 1. the control group was fed a diet without carvedilol for a period of two weeks. Groups 2, 3 and 4 were fed for two weeks a diet containing carvedilol, 1-3-10 mg/kg/day resp. After completed medication in all animals ischaemia of the kidney was induced...
[Analysis of perception in patients during an acute attack of bronchial asthma].
Z Paráková, B Král
Vnitr Lek 1997, 43(11):712-714
An analysis of subjective sensations during an asthmatic attack in 51 asthma patients was performed. A difficult inspiration or inspiration and expiration was the most prevalent sensation, while isolated difficult expiration was only sparse finding. A tightness on the chest was often noticed as well. The probable explanation for these observation could be the breathing a high lung volume (hyperinflation), caused by closing small airway a mostly due to bronchoconstriction during the asthmatic attack. The authors suggest not to generally use the term "expiratory breathlessness" when describing the clinical picture of an asthmatic attack.
[Levels of CK MB mass in patients with acute myocardial infarct treatedwith fibrinolysis. Comparison with levels of CK, CKMB, CKMB mass and troponin T in the diagnosis of coronary ischemia].
J Bastecký, J Vávrová, V Palicka, E Ettlerová, V Wasyliwová, V Rehácek
Vnitr Lek 1997, 43(11):715-721
In a group of 26 patients with AIM the CKMB value was raised above the discrimination level already on admission--on average 2.7 +/- 1.4 hours after development of ischaemic pain--in 46% patients. The maximal value of CKMB mass was achieved in the group with probable reperfusion 12.1 +/- 3.8 hours after the development of ischaemic pain and this value was elevated in relation to the discrimination value 41.5 +/- 17x and in relation to the so-called basal value 145 +/- 117x. In the group without probable reperfusion the maximal value was achieved significantly later, after 19.8 +/- hours and was elevated in relation to the discrimination value 31 +/-...
[The effect of 4 years' of hypolipemic treatment on the width of the common carotid artery intima in patients with familial hyperlipidemias].
J Spácil, R Ceska, J Petrásek, J Sobra
Vnitr Lek 1997, 43(11):722-727
Sixty-four patients with familial hyperlipoproteinaemia were treated for almost four years by dietetic treatment and various hypolipidaemic drugs. In 25 patients with familial hypercholesterolaemia who had clinical signs of ischaemic heart disease total and LDL-cholesterol declined and the width of the intima of the common carotid artery diminished from 0.78 mm to 0.69 mm (p = 0.004). In the above artery the maximal flow rate of blood declined. The increase was, however, not statistically significant. In 12 patients with familial hypercholesterolaemia who suffered from ischaemic heart disease the width of the intima of the common carotid artery and...
[10 years' of care of adult patients with cystic fibrosis].
J Musil, H Rozehnalová, M Kvapil
Vnitr Lek 1997, 43(11):728-732
The authors summarized the results of ten years care of adult patients with cystic fibrosis (CF). They treated a total of 45 patients incl. 26 men and 19 women. Nineteen patients (42%) died. The most frequent cause of admission to hospital was respiratory infection (84%), planned antibiotic treatment (6.5%), pneumothorax (6%) and haemoptysis (4%). In all patients impaired ventilation of the obstructive type was found. The mean annual decline of FEV1 was 0.173 +/- 0.194 l, VC 0.303 +/- 0.323 l. The authors did not find a significant difference between live and dead patients. The mean annual increase of PaCO2 was 0.5 +/- 0.87 kPa, the mean annual decrease...
[Endogenous levels of somatostatin, C-peptide and insulin in acute pancreatitis].
S Aleryani, M Huorka, J Payer, I Duris, P Ondrejka, H Kratochvíµová
Vnitr Lek 1997, 43(11):733-737
The authors compared in seven patients with acute pancreatitis the levels of endogenous somatostatin, insulin and C-peptide to assess their mutual correlation and relation to the development of the disease and serum amalyse levels. The results were compared with values recorded in 11 healthy volunteers. The levels of endogenous somatostatin were in patients with acute pancreatitis significantly higher (p < 0.05) than in the control group. The authors found an inverse relationship between the somatostatin and amylase level (correlation coefficient 0.75). They did not observe a significant correlation between somatostatin and insulin levels nor between...
[Significance of vegetative nerve tone in patients with vasovagal neurocardiogenic syncope].
R Dvorák, R Lábrová, N Honzíková, M Sisáková, B Semrád
Vnitr Lek 1997, 43(11):738-743
The timely provided and precise diagnostic of the syncopal states as well as their causal therapy is a main subject of many medical branches interest within last time. Our work was concentrated on a vasovagal neurocardiogenic syncope. The definition of the vegetative nervous tonus participation on its development by a method of evaluation of the heart rate variability as well as the review of a possibility to the application of quantification these results to a prediction of vasovagal reaction, respective of its malignant variant, was the main aim of our effort. Our results enable a conclusion, that the observation of aquiet autonomic nervous tonus...
[Plasminogen activator inhibitor (PAI-1) and markers of endothelial dysfunction in patients with diabetes mellitus].
P Galajda, E Martinka, D Baláz, J Stasko, J Kerný, E Planková, M Mokán, P Kubisz
Vnitr Lek 1997, 43(11):744-747
The authors examined 25 patients with diabetes mellitus type 2 (NIDDM) without vascular complications, treated by sulphonyl urea preparations, 12 hyperinsulinaemic (HI) non-diabetic subjects and 11 normoinsulinaemic healthy subject s. Patients with NIDDM and HI non-diabetics had significantly elevated PAI-1 levels which correlated with the C-peptide level (r = 0.519, p < 0.001), triacylglycerols (TG) (r = 0.685, p < 0.001), BMI (r = 0.607, p < 0.001) and levels of endothelial markers such as von Willebrand s factor and thrombomodulin (TM). In the group of patients with NIDDM no relationship of PAI-1 and C-peptide was found and a significant...
[The effect of sulodexide, a glycosaminoglycan, on albuminuria in diabetic patients].
J Perusicová, J Skrha
Vnitr Lek 1997, 43(11):748-752
UNLABELLED: The authors administered to type 1 diabetics (n = 15) or type 2 diabetics (n = 20) with microalbuminuria or macroalbuminuria for a period of 15 days i.m. doses of sulodexide (Vessel Due F), 600 i.u. (i.e. 60 mg). The evaluation of the whole group revealed a statistically significant reduction of the original mean value of albuminuria (509 +/- 127 ug/min) already during the first week of sulodexide administration (382 +/- 105). A further decrease was recorded after the second and third week of treatment (326 +/- 89, 319 +/- 85 ug/min). While in diabetics with microalbuminuria < 100 micrograms/min the mean levels of excreted albumin were...
[Calciphylaxis in a patient on long-term dialysis].
V Herout, A Ryska, D Pohnětalová, Z Nozicka, P Fixa, B Hájková
Vnitr Lek 1997, 43(11):753-755
Calciphylaxis is a special form of soft tissue calcification (in particular blood vessels), affecting specially patients with chronic renal insufficiency and associated secondary hyperparathyroidism. Most severely affected are small arteries with a diameter of 0.2-0.5 mm at the interface of the corium and subcutaneous layer. Calcification of the vascular media with subsequent narrowing of the lumen causes ischaemic changes manifested by the development of painful reddish-violet spots on the skin with necrosis and ulcerations. The authors describe the case of a 73-year-old diabetic female patient with regular dialyzation treatment. The patient developed...
[Autologous transplantation of peripheral hematopoietic cells in a patient with multiple myeloma and renal insufficiency].
M Krejcí, M Doubek, Z Adam, R Hájek, J Vorlícek, J Mayer
Vnitr Lek 1997, 43(11):756-758
High dosage melfalan chemotherapy with subsequent autologous blood stem cell transplantation in suitably selected patients with multiple myeloma greatly increases the probability that complete remission will be achieved and it prolongs the mean survival period as compared with classical chemotherapy. Till recently patients with multiple myeloma and renal insufficiency were not included in transplantation programmes. Only recently several papers were published abroad which indicate the possibility to implement transplantations also in these patients. The authors describe the treatment, incl. the first autologous transplantation of blood stem cells in...
[Stress echocardiography in "non-ischemic myocardial disease"].
L Elbl, V Chaloupka
Vnitr Lek 1997, 43(11):759-764
Stress echocardiography is nowadays an integral part of the diagnosis of ischaemic heart disease. In the submitted review the authors draw attention to the fact that ischaemic heart disease is no longer the domain of stress echocardiography. In recent years the interest of cardiologists in this method increased also in other cardiac diseases. Based on the appropriate pathophysiological mechanism of cardiac affection stress echocardiography is used to test left ventricular function after a dynamic or pharmacological stress, i.e. increased cardiac activity and cardiac minute volume in a number of heart diseases where we must know the extent of left ventricular...
[Present trends in the pathogenesis, diagnosis and therapy of vasovagal syncope].
P Mitro, D Trejbal
Vnitr Lek 1997, 43(11):765-769
Vasovagal syncope is the most frequent cause of syncopal conditions. In its pathogenesis autonomic nervous, neurohumoral, cerebrovascular and other mechanisms participate. The gold standard in the diagnosis of vasovagal syncope is in recent years the head up tilt test. In treatment pharmacotherapy, cardiac pacing or their combination can be used.