[Leptin in persons with simple obesity].

D Stejskal, V Růzicka, L Hrubísková, J Hrebícek, J Bartek, M Franková, R Pastorková, P Mohapl, J Vávrová

Vnitr Lek 1997, 43(9):555-561

Obesity is a disease with distinct genetic determination and its phenotype is defined by the still unknown number of genes whose expression can be influenced by environmental factors. Several years ago, "obesity gene" was isolated in animals. This gene, coding protein which consists of 165 amino acids, is called leptin. Leptin is supposed to be a key substance controlling homeostasis of body weight and energy balance; it is produced by adipocytes and its value correlates highly significantly with anthropometric parameters that characterize physical constitution and amount of subcutaneous fatty tissue. The obese individuals often display hyperleptinemia...

[The effects of nicotine on leptin levels in patients with android obesity].

J Hrnciar, M Katreniaková, J Lepej, J Okapcová

Vnitr Lek 1997, 43(9):562-565

In insulin resistant subjects with android obesity the leptin levels are, as compared with non-obese subjects, elevated in proportion to their BMI, WHR and their percentage of body fat. Generally independent on obesity, leptin levels are significantly higher in women than in men as in women the percentage of adipose tissue is higher. After administration of 2 mg nicotine in Nicorette chewing gum to 36 android obese non-smokers the elevated baseline values of leptin did not change and thus the observation that cigarettes suppress hunger or that smoking promotes weight reduction is untrue or else this effect is not mediated by nicotine stimulation of...

[The metabolic syndrome, its heredity, methods of detection and clinical significance].

J Válek, Z Vlasáková

Vnitr Lek 1997, 43(9):566-573

BACKGROUND: The metabolic syndrome is a common denominator of a number of risk factors which are associated with type 2 diabetes and serious cardiovascular complications. The symptoms develop on the background of insulin resistance and are associated with hyperinsulinism. They are not manifestations of ageing, but are developing probably on a predisposed background already in young age.METHODS AND RESULTS: In the families of 39 probands with symptoms of the metabolic syndrome (MS) there were 58 offspring, mean age. 26.4 +/- 8.7 years. They were compared with 46 controls matched for age, BMI and sex without a family-history of metabolic diseases....

[Effect of a revascularization procedure on functioning of the hibernating myocardium].

M Aschermann, I Vaněk, V Vondrácek, J Veselka, J Bultas, F Holm, J Humhal

Vnitr Lek 1997, 43(9):574-579

Persistent abnormalities of left ventricular wall motion in patients with chronic coronary artery disease can be reversed by successful coronary artery bypass surgery or coronary angioplasty. The identification of hibernating myocardium has therefore important therapeutic and prognostic implications. Echocardiography with low dose dobutamine infusion can detect viable myocardium in patients with chronic left ventricular dysfunction. We have studied 32 patients with angiographically confirmed coronary artery disease and left ventricular dysfunction. The effect of dobutamine infusion (5 micrograms/kg/min. followed by 10 micrograms/kg/min) on left ventricular...

[What are the trends in cardiovascular pharmacotherapy in recent years in patients after myocardial infarct?].

J Widimský, Z Skodová

Vnitr Lek 1997, 43(9):580-583

The authors compared the status of pharmacotherapy in 587 patients with myocardial infarction in 1991 according to the MONICA study, in hospitals of six districts in the Czech Republic, age group 25-64 years with data for 1995 assembled by means of questionnaires in 749 patients of the same age group, who were after myocardial infarction in selected spas. Thrombolytic treatment proved quite inadequate in 1988-1993 in six districts of the Czech Republic, although it rose slightly from mere 2.9% in 1988 to 11.1% in 1993. In 1995 25.4% patients with acute myocardial infarction were treated by thrombolytic treatment. Conversely anti-platelet treatment...

[Pulsed doses of calcitriol in the treatment of secondary hyperparathyroidism in patients on hemodialysis].

I Sotorník, R Petrásek, O Schück, M Adamec, I Smrcková, J Tocík

Vnitr Lek 1997, 43(9):584-591

Administration of pulse doses of calcitriol is a better way of conservative treatment of secondary hyperparathyroidism (2HPT), making use of the direct suppression of parathormone (PTH) secretion. In a group of 29 haemodialyzed patients the authors evaluated during a six-month follow-up the effect of intravenous Calcijex in 12 and of oral Rocaltrol in 8 subjects. In responders of the calcijex group the PTH level declined by 67.6%, the mean baseline PTH value being 787.8 pg/ml, as compared with non-responders where the decline of PTH at the end of the investigation was 7.5%, the baseline PTH being 1296.4 pg/ml. The difference was significant (p <...

[Detection of myeloma cells in the peripheral blood using flow cytometry].

Z Adam, M Klabusay, J Vorlícek, R Hájek

Vnitr Lek 1997, 43(9):592-598

Bone marrow plasma cells from patients with multiple myeloma express monoclonal cytoplasmic immunoglobulin, strongly express CD38 and usually coexpress CD56 and CD54. The aim of this study was to learn the relationship between the number of CD38+CD56+ and CD38+CD54 positive cells in peripheral blood with the activity of multiple myeloma. We evaluated the number of these cells in patients with monoclonal gammopathy and in the control group, as well. We used the two-color flow cytometry for this purpose. The peripheral blood of 57 patients with multiple myeloma and 4 patients with monoclonal gammopathy of unknown significance was repeatedly analyzed....

[Hereditary hemorrhagic telangiectasis and the development of an arteriovenous fistula after 24 years].

M Takác, S Koval, J Klimcík

Vnitr Lek 1997, 43(9):599-601

The authors describe a unique pulmangiographic picture taken 24 years after the first angiographic examination made on account of repeated haemoptysis associated with Rendu-Osler-Weber s disease. Angiography revealed enlargement of the aneurysm in the lungs and dilatation of the afferent and efferent vessel of the aneurysm. The only treatment of pulmonary arteriovenous fistulas is surgical.

[Simultaneous occurrence of 2 thyroid gland carcinomas].

J Macák, J Dvorácková, M Michal, H Vaverková, J Němec

Vnitr Lek 1997, 43(9):602-606

The concurrent finding of two thyroid carcinomas is rare. The authors present two patients with the concurrent occurrence of two tumours. In the first case--a 51-year-old man--the authors found a medullary carcinoma in the right lobe and a medullary papillary carcinoma in the left thyroid lobe. The medullary papillary carcinoma metastatized into the mediastinal lymph nodes and into the mediastinal tissues in the area above the tracheal bifurcation. From the morphological and immunohistological aspect in the primary tumour of the left lobe as well as in the mediastinum two different clones of tumour cells were found (the medullary component of the tumour...

[Octreotide in the treatment of thyrotropin-secreting pituitary adenomas].

J Podoba, P Hnilica, I Makaiová, S Kovácová, M Rybár, K Gecík, V Belan, J Steno

Vnitr Lek 1997, 43(9):607-610

The authors detected in a 30-year-old patient a very rare type of hyperthyroidism caused by a thyrotropin secreting pituitary adenoma. Scintigraphic examination of the pituitary by means of 111In radiolabelled octreotide revealed an increased accumulation of the radiopharmaceutical preparation in the tumour, which confirmed the high density of somatostatin receptors. After onset of octreotide treatment (Sandostatin, Sandoz, Switzerland) 3 x 100 ug/day by the s.c. route a brisk decline and normalization of thyrotropin already after the first dose was recorded. The thyroxine concentration declined slowly to the upper range of normal values. After 5 months...

[Thyrotropin-secreting adenomas of the hypophysis].

J Podoba, P Hnilica, I Makaiová, A Kovác

Vnitr Lek 1997, 43(9):611-614

Thyrotropin secreting pituitary adenomas are scarce. They may cause an extremely rare form of hyperthyroidism. The diagnosis is often delayed because the clinical symptoms are attributed to common types of hyperthyroidism. The diagnosis involves detection of elevated or normal (unsuppressed) thyrotropin levels in hyperthyroid patients and evidence of a pituitary adenoma by computed tomography or magnetic resonance imaging. The thyrotropin response in the thyrotropin-releasing hormone test is either absent or insufficient. When the pituitary microadenoma appears to be undetectable, the familiar syndrome of selective pituitary resistance to thyroid hormones...

[Relation between parathormone and 1,25-dihydroxyvitamin D3 in chronic kidney failure].

I Sotorník

Vnitr Lek 1997, 43(9):615-619

The author gives an account of the basic relations of calcium homeostasis ensuing from the action of calcitropic hormones under physiological conditions and during chronic renal failure. The following are evaluated in relation to the pathogenesis of secondary hyperparathyroidism: a decline of glomerular filtration, the relationship of serum calcium levels and PTH secretion along with analyses of so-called S curves, calcitriol deficit and impaired function of the appropriate receptors, phosphate retention, effect of metabolic acidosis, participation of retained aluminium, possible importance of calcitonin and genetic abnormality, corticoid administration...

[Treatment of diabetes with a new type of insulin--Humalog].

M Dryáková

Vnitr Lek 1997, 43(9):620

[Recommendations for the diagnosis and therapy of hyperlipoproteinemias in adults prepared by the Czech Atherosclerosis Society].

T Ceska, R Cílková, R Poledne, H Rosolová, V Soska, J Simon, J Sobra, H Vaverková, J Widimský, J Widimský, Z Zadák

Vnitr Lek 1997, 43(9):621-625