[The treatment of multiple myeloma with an allogeneic peripheral blood stem cell transplantation using a non-myeloablative conditioning regimen].

M Kmonícek, L Jebavý, M Lánská, P Zák, J Malý, V Maisnar

Vnitr Lek 2000, 46(7):377-383

Between November 1998 and October 1999 authors treated five multiple myeloma patients with an allogeneic peripheral blood stem cell transplantation from HLA-identical sibling using a non-myeloablative conditioning regimen. The median age at the time of transplantation was 58 (range: 47-65) years. In all patients one (n = 3) or two (n = 2) autologous peripheral blood stem cell transplantations were already performed. Conditioning was performed with fludarabine, oral busulfan and anti-T-lymphocyte globulin. All patients engrafted from 13 to 18 (median: 17) days from transplantation. The duration of neutropenia (absolute neutrophiles count < 500/microl)...

[Helicobacter pylori negative gastroduodenal lesions in subjects treated with NSAID].

M Kunovská, P Dítě, J Lata, J Dolina, J Prásek

Vnitr Lek 2000, 46(7):384-386

The authors examined retrospectively the frequency of NSAID use by patients with gastroduodenal ulcer without HP. The objective was to evaluate whether the use of NSAID is the predominating factor in the development of ulceration in subjects with HP negative ulceration. The group comprised 525 patients with confirmed presence of H, incl. 52 who used NSAID. From the results ensues that the incidence of ulcerous lesions with HP negativity and NSAID medication is significantly higher than in subjects who use NSAID and suffer from a confirmed HP infection.

[EBV-positive Hodgkin's lymphoma in children under 10 years].

J Macák, L Plank, B Habanec, P Fabián, R Curík, J Nieslanik, L Bobot, P Vácha, Z Utíkal, J Dvorácková

Vnitr Lek 2000, 46(7):387-390

The number of EBV-positive child patients with HL varies in different countries and regions. In developing countries the number of child patients with this disease is higher than in the patient population of economically advanced countries. The authors examined 24 patients under 10 years with Hodgkin's lymphoma. Twenty patients were males, four females. In ten cases according to histological examination type II of HL was involved--nodular sclerosis (7 boys, 3 girls). In 14 instances the authors detected the mixed cellularity type (13 boys and 1 girl). EBV positivity was assessed immunohistologically by means of the antibody against LMP-1 and EBER-1...

[The 6M 12M trial--study of the effectivess and tolerance of treatment in chronic myeloid leukaemia with a combination of interferon alfa and cytarabine].

E Tóthová, M Fricová, N Stecová, E Svorcová, T Guman, S Rraffac, A Kafková, M Hlebasková

Vnitr Lek 2000, 46(7):391-394

OBJECTIVE: Comparing the conventional treatment after the interferon alpha treatment the number of hematologic as well as cytogenetic responses increases. With the cytogenetic response is associated a longer survival. Today is interferon alpha considered to be the first line treatment in those patients with chronic myeloic leukaemia, who are not candidates for alogenic bone marrow transplantation. The combination with cytosinarabinoside can reduce the number of Ph positive metaphases.DESIGN AND METHODS: Forty-three previously untreated patients with CML in chronic phase were randomly assigned to receive either IFN alpha 2 b (5MU sqm/daily) or IFN...

[Diagnosis and treatment of hepatic cysts].

T Krechler, M Kaláb, M Brodanová, R Brůha, Z Marecek

Vnitr Lek 2000, 46(7):395-397

Hepatic cysts are at the present time of widespread use of abdominal ultrasonography a frequent finding. The authors summarize contemporary diagnostic possibilities of liver cysts and submit variants of the therapeutic procedure in case of symptomatic liver cysts. They present their own experience with the treatment of hepatic cysts by the evaluation method combined with administration of 96% ethanol into the cyst. They compare this therapeutic procedure with the method of simple evaluation of the contents of the cyst. The method of evaluation of hepatic cysts under ultrasonographic control with subsequent administration of 96% alcohol appears to be...

[Cytokines in cardiovascular diseases. Role in pathogenesis, effect on prognosis, therapeutic perspectives].

M Penicka, P Gregor

Vnitr Lek 2000, 46(7):398-402

During the last ten years many papers were published providing evidence of elevated serum concentrations of different cytokines in the majority of cardiovascular dieseases. Eventually it was demonstrated that they exert various effects on the heart muscle and vascular wall and thus have an impact on the patient's prognosis. Nowadays even a cytokine hypothesis of cardiovascular diseases exists. The objective of the work is to give an account of contemporary findings on the importance of cytokines in the pathogenesis of cardiovascular diseases and possibilities of therapeutic interventions.

[Vascular endothelial dysfunctions, possible detection and treatment].

T Sejda

Vnitr Lek 2000, 46(7):403-407

The basic physiological functions of the endothelium are functions of a semipermeable membrane, control of optimal vascular patency and safeguarding of the vascular integrity. Endothelial dysfunction may be considered the first functionally important stage of atherosclerosis. The most frequent evoking factors include hyperlipoproteinaemia, arterial hypertension, smoking and diabetes mellitus. The clinically most important manifestations of impaired endothelial function are disorders in the coronary circulation and transient cerebral ischaemias. Ways of detection of endothelial dysfunctions include invasive methods and at present non-invasive ultrasonic...

[Idiopathic hypoparathyroidism with celiac disease--diagnostic and therapeutic problem].

Z Frysák, Y Hrcková, Z Rolinc, Z Hermanová, J Lukl

Vnitr Lek 2000, 46(7):408-412

A middle-aged woman developed gradually diseases where most probably the common denominator is an autoimmune process. The authors describe the clinical condition persisting for seven years, where hypoparathyroidism was associated with coeliac disease which did not respond to dietary measures. Malabsorption was manifested by a selective block for calcium absorption from the gut. The impaired conversion of vitamin D2 to D3 is of interest; it has obviously a multifactorial etiology. The main problem is the patient's tendency to respond by tachyphylaxis to oral vitamin D administration. The only effective therapeutic procedure apart from those listed is...

[Uncommon combination of multiple myeloma in three patients].

F Mateja, J Malý, M Tichý, F Langr

Vnitr Lek 2000, 46(7):413-417

The authors describe uncommon combinations of multiple myeloma in three men aged 83, 63 and 55 years. In patient no. 1 both diseases--pernicious anaemia and multiple myeloma IgG-kappa were detected simultaneously. In patient no. 2 Crohn's disease preceded multiple myeloma IgA-lambda by more than 30 years. In patient no. 3 Gaucher's disease preceded multiple myeloma with paraproteinaemia IgA-lambda and IgG-kappa by more than 10 years. The diagnosis was facilitated by examination of the bone marrow, immunochemical examination of serum and urine and X-ray examination of the skeleton. In all patients the development of the myeloma had an adverse effect...

[Chronic mesenteric ischemia].

F Musil, P Kouhout, P Eliás, A Krajina, M Podhola

Vnitr Lek 2000, 46(7):418-422

Chronic mesenteric ischemia often called intestinal angina too, is the clinical syndrome that originates as a result of chronic obstruction of the splanchnic arteries. Intestinal angina is defined by the clinical triad of postprandial abdominal pain, sitophobia (fear of eating) and chronic weight loss. Postprandial abdominal pain is analogous to angina pectoris and calf claudication, two more common manifestations of episodic tissue hypoxia. The authors present the case-history of a 50-year-old woman with intestinal angina due to obliteration of the all three main splanchnic arteries. The authors describe the course of the disease and point out new...

[Severe sepsis with organ failure in necrotizing fasciitis of the right leg caused by infection with Vibrio vulnificus].

J Vecer, H Kubátová, P Hanek, A Esnerová, H Klazarová, Lochmann

Vnitr Lek 2000, 46(7):423-425

Vibrio vulnificus is a human pathogen which can cause the septicemia and necrosis of the soft tissue, especially fasciitis. The occurrence is most common in the summer, the source of infection can be sea water or the sand on the beaches, however the infection after eating seafood was described as well. The patient with predominant liver dysfunction are more often affected. The clinical course is characterized by severe sepsis, and massive skin lesion. The mortality more than 60% is reported. This case report describes the course of disease in 64 year old patient, who has spent his vacation in Bulgaria. After return he was admitted with severe sepsis...

[What is the future of internal medicine in Europe? Will it be apoptosis, necrosis or adaptation and remodeling?].

L Kotík

Vnitr Lek 2000, 46(7):426-428