Vnitřní lékařství, 1998 (vol. 44), issue 6
[Renal excretion of potassium in individuals with stabilized function of a transplanted kidney].
O Schück, J Stríbrná, V Teplan, S Vítko, I Matl, J Skibová, M Stollová
Vnitr Lek 1998, 44(6):315-319
From previous work it is known that in subjects with a transplanted kidney treated with cyclosporin A hyperkalaemia may develop even if the glomerular filtration rate is within the normal range or only slightly reduced. The mechanism of this defect was not elucidated so far. In the present work the authors try to study the question whether and how renal potassium excretion by the transplanted kidney is influenced by the intensity of sodium excretion. Focused on renal excretion of potassium, sodium, chlorides, all osmotically active substances, glomerular filtration rate (polyfructosan clearance) and renal plasma flow (paraaminohippuric acid clearance)...
[Paired filtration dialysis--evaluation of effectiveness of the method].
J Eiselt, J Racek, K Opatrný
Vnitr Lek 1998, 44(6):320-325
Paired filtration dialysis (PFD) is a haemodiafiltration method which uses in a major way the convection as well as the diffusion principle of blood clearance. It is the only method replacing renal function where blood filtration is separated from diffusion. The objective of the study is to make the medical community familiar with this method and to assess the effectiveness of PFD when two types of haemodiafilters are used. The effectiveness of PFD is also compared with haemodialysis where a highly permeable haemofilter is used (high-flux haemodialysis, HFHD) with a medium-size area. A group of 8 dialyzed patients was treated after weekly intervals...
[The TEAM study--a study of the effectiveness and tolerance of treatment of essential hypertension with a fixed combination of trandolapril and verapamil].
J Widimský, R Dzúrik
Vnitr Lek 1998, 44(6):326-331
The TEAM trial investigated the effectiveness and tolerance of a fixed combination of the ACE inhibitor and calcium channel blocker (2 mg trandolapril and 180 mg verapamil retard) (preparation Tarka) in an open multicentre prospective study of treatment of moderately severe hypertension (diastolic pressure at the end of the two-week wash-out period 100-115 mm Hg). The trial comprised 163 patients who were treated first for four weeks by a monotherapy with 2 mg trandolapril. After these four weeks patients who attained normal blood pressure proceeded with trandolapril treatment. Hypertensive patients who did not attain normal diastolic pressure levels...
[Ramipril in the treatment of moderate to moderately severe hypertension. A multicenter open study].
J Spinar, J Vítovec
Vnitr Lek 1998, 44(6):332-335
A twelve-week open trial investigating the effect and tolerance of ramipril in 685 patients with mild to moderate hypertension in 88 clinics mostly of general practitioners (list with the author). The antihypertensive effect was investigated after 4, 8 and 12 weeks. The trial was terminated consistent with the protocol by 501 (73.1%) patients, 36 (5.3%) were eliminated early and in 148 (21.6%) the prescribed protocol was not respected. 413 patients (82.4%) terminated the trial on monotherapy, the remaining 88 (17.6%) had combined treatment from the 8th week onwards. When the trial with monotherapy was terminated the drop of blood pressure was more...
[The effect of ramipril on metabolic, renal and cardiac function in hypertension and type II diabetes mellitus].
J Vítovec, J Spinar
Vnitr Lek 1998, 44(6):336-341
OBJECTIVE: To assess the effect of ramipril on indicators of glucose metabolism, incl. insulin resistance, on renal function with microalbuminuria, changes of some echocardiographic signs of hypertrophy and compliance of the left ventricle in patients with hypertension and type II diabetes mellitus.MATERIAL AND METHODS: The authors examined 32 patients with hypertension grade I and II and with diabetes type II, who had ramipril, 2.5-10 mg/day, for a period of six months. The examination before and after long-term treatment comprised basic biochemical sampling incl. concentrations of immunoreactive insulin, C-peptide and glycated haemoglobin and...
[Optimalization of rate adaptation using Holter functions in DDD/R pacemakers].
T Novotný, R Dvorák, M Kozák, J Vlasínová
Vnitr Lek 1998, 44(6):342-346
Introduction of the pacing rate adaptation according to the momentary metabolic needs added other programmable parametres which demand physician's attention during the initial postimplantation programmation and also in follow-up of pacemaker patients. The parametres setting is strictly individual with a need of feedback control. In some devices it is enabled by Holter functions as a part of pacemaker software. These methods were used to set the rate adaptive parametres in the group of 23 patients with implanted DDD/R pacemaker. The walking stress test was used. Model follow-up situations are presented in 3 case reports. Using Holter functions enables...
[Hemoglobin Sydney--alpha beta 2 67 (E11) Val-Ala and hemoglobin Olomouc alpha 2 beta 2 86 (F 2) Ala-Asp in Czech families. DNA sequence analysis for a more accurate diagnosis of hemoglobinopathies].
K Indrák, V Divoký, E Kynclová, M Divoká, R Melichárková, J Indráková
Vnitr Lek 1998, 44(6):347-349
The paper demonstrates the importance of sequence analysis of DNA for the identification of Hb-Sydney [alpha2-beta2 67 (E11) Val-Ala]. The latter was considered erroneously, based on results of biochemical analyses to be Hb-M-Milwaukee [alpha2 beta2 67 (E 11) Val-Glu]. With the unstable Hb-Sydney correspond also phenotypical manifestations of disease (haemolytic anaemia with Heinz bodies in red blood cells). Sequence analysis of DNA of patients with Hb-Olomouc [alpha 2 beta 2 (F 2) Ala-Asp] revealed that mutation of Ala-Asp in position 86 (F 2) of the beta globin chain is coded by mutation C-->A (GCC-GAC).
[Monitoring cytomegalovirus infection using the 2-step nested polymerase chain reaction in patients with allogenic bone marrow transplantation].
P Jindra, V Koza, P Cetkovský, P Hájek, M Svecová
Vnitr Lek 1998, 44(6):350-354
Cytomegalovirus infections and their sequelae are the most serious complications in patients after allogenic bone marrow transplantations. Therefore in recent years quite rightly attention is paid to new diagnostic methods which make earlier and more sensitive detection of incipient CMV infection possible. The method of the two-stage polymerase chain reaction (PCR) was used for early detection of CMV infection and its possible further monitoring in 38 recipients of allogenic bone marrow. A positive result was recorded in 15 (39%) patients whereby in 10 (13%) repeated positivity was involved. In three in this group of patients (8%) CMV disease developed,...
[Clinical development of unstable (brittle) diabetes mellitus, its therapy and prognosis].
M Dryáková, J Cerovská, H Vondrová, T Sosna
Vnitr Lek 1998, 44(6):355-360
Treatment of labile (brittle) diabetes characterized by variations of the blood sugar level, liability to develop ketoacidosis and in susceptible subjects the development of organ complications, was always a serious problem. The objective of the present work is to evaluate the results of a long-term study concerned with the relationship of compensation, vascular and neurological complications of labile insulin-dependent diabetics. The authors investigated indicators of compensation, and in collaboration with an ophthalmologist, and neurologist also signals of possible damage of the eye, central and peripheral nerves, kidneys. The results achieved by...
[Leptin, insulin and proinsulin--their relationship].
D Stejskal, L Jedelský, J Bartek, V Růzicka
Vnitr Lek 1998, 44(6):361-365
Leptin is protein produced by mature adipocytes into the system circulation and gives information to hypothalamic centers about fat amount in the organism. Leptin is supposed to play a causal role in energy output of the organism and influences the appetite (antiobese effect). Obese individuals were proved to have frequently hyperleptinemia. This disease is caused by a postreceptor disorder (however, several obese families had also normoleptinemia or even hypoleptinemia which is caused by polymorphism of Ob-gene). It was also found that leptin administration in animals leads to reduced appetite and decreased body weight. Interpretation of leptinemia...
[Retroperitoneal hematoma and femoral compression neuropathy--a complication of anticoagulation therapy after myocardial infarct].
P Kristian, R Kucinský, J Gonsorcík, P Jonás, A Tokarcíková, J Lazúr, T Jurgová, J Tomasch
Vnitr Lek 1998, 44(6):366-369
Anticoagulant treatment with coumarins is due to it unequivocal benefit and relatively low risk increasingly used for prevention of sudden cerebrovascular attacks, in atrial fibrillation, in the treatment of thromboembolic disease, as part of treatment after replacement of cardiac valves and other diseases. With the increasing number of indications and patients treated with oral anticoagulants the number of haemorrhagic complications is increasing. The submitted case-history demonstrates an uncommon haemorrhagic complication, retroperitoneal haematoma associated with a neurological symptomatology in a 59-year-old patient who had prolonged anticoagulant...
[Molecular biology aspects of Hodgkin's disease].
J Macák
Vnitr Lek 1998, 44(6):370-372
Immunohistological methods did not elucidate the etiology and pathogenesis of Hodgkin's disease. In "classical" cases the immunophenotype is based on evidence of three markers: CD30+, CD15+, CD20-. Despite the use of more recent methodical approaches a considerable percentage of Hodgkin and RS cells with CD15 antibody is negative. The Epstein-Barr virus (EBV) plays an important part in the development of malignant disease and at the same time a number of nuclear antigens can be detected: EBNA-1, EBNA-2, EBNA-3a,-3b,-3c,LP. Also latent membrane proteins LMP-1, -2a, -2b and two small ribonucleic acids described as EBER-1, EBER-2. Bcl-2 protein was detected...
[Clinical use of hematopoietic growth factors in the treatment of acute myeloblastic leukemia].
E Tóthová
Vnitr Lek 1998, 44(6):373-377
Contemporary anti-tumourous treatment of acute myeloblastic leukaemia (AML) is more and more aggressive and myelotoxic and increasing numbers of patients are threatened with serious infectious complications. The administration of haematopoietic growth factors (CSF) during the period of severe postcytostatic neutropenia holds an important place in the treatment of AML. Administration of G-CSF and GM-CSF during the period of severe neutropenia leads to regeneration of granulopoiesis, it reduces the incidence, severity and duration of neutropenia and the number of infectious complications. Haematopoietic growth factors are also part of programmes of allogenic...