[Electrophysiologic parameters determining the success of radiofrequency ablation of atrioventricular reentry tachycardia].

P Heinc, M Fiala, J Lukl

Vnitr Lek 2001, 47(6):343-347

The main objective was to assess electrophysiological parameters which may be important for effective radiofrequency ablation of accessory atrioventricular pathways. In a group of 66 patients a total of 490 applications of radiofrequency current were made, incl. 68 which led to successful severing of the accessory pathways. The ablations were successful in 65 patients (98.5%). The potential of the accessory pathways was present in effective ablations in 19 cases of 68 applications (28%), while in ineffective ablations it was present in 13 cases of 421 applications (3%, p < 0.001). Stability of the electrogram was found in all 68 effective ablations...

[Heart failure in hypertensive patients with left ventricular hypertrophy].

M A Ghanem Wisam, P Mikes, J Bulas, K Kozlíková, O Sleiman, J Murín, A Reptová

Vnitr Lek 2001, 47(6):348-353

Left ventricular hypertrophy (LVH) is supposed to be a useful marker of cardiovascular complications during the course of hypertension. Authors compared the presence of heart failure, left ventricular diastolic dysfunction and chronic atrial fibrillation in hypertensive patients with and without left ventricular hypertrophy defined by echocardiography. Hospital records of 192 hypertensives treated in our medical department during years 1996-1999 were analysed. Left ventricular hypertrophy was defined by echocardiography (Penn convention) as left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women. Presence of LVH was found in 128...

[Acute hemorrhage of the upper digestive tract--personal experience].

L Husová, J Lata, M Senkyrík, V Procházka, J Boudný, Z Pavlovský, P Husa

Vnitr Lek 2001, 47(6):354-360

The authors submit a retrospective investigation of 50 patients hospitalized at the intensive care unit of the Medical gastroenterological department, Faculty Hospital Brno treated in 1999 with the diagnosis of acute haemorrhage into the upper digestive tract. In the investigated group the most frequent cause of haemorrhage was portal hypertension (21 patients, 32.8%) and a peptic gastroduodenal lesion (15 patients, 23.4%). During the investigation period 12 patients died (18.8%), 6 developed haemorrhage as a complication of a serious condition (decompensated cirrhosis of the liver). In haemorrhage from oesophageal and gastric varicosities pharmacotherapy...

[Implantable cardioverter-defibrillators in the prevention of sudden cardiac death].

M Kozák, L Krivan, B Semrád

Vnitr Lek 2001, 47(6):361-370

The aim of this work is to characterize and analyse the spectrum of therapies delivered from implantable cardioverter-defibrillators (ICD), to evaluate their effectivity and to mark the most effective types of antitachycardia stimulations (ATP), cardioversion (CV) and defibrillation (CD). To compare our results with references and give precautions of trouble-shootings. Our patients had implanted ICDs according to standard criteria for ICD implantations. Before discharge from hospital we performed predischarge test of their ICD. Than we followed them periodically each three months. We have observed 72 ICD pts (55 M, 17 F) in the mean age of 62.7 +/-...

[Intestinal permeability in relatives of patients with Crohn's disease].

P Kohout, P Koref

Vnitr Lek 2001, 47(6):371-374

The etiology of Crohn's disease remains unknown, one of theories is the damage of bowel wall with the impairment of small bowel barrier. In patients with Crohn's disease was found high level of small bowel permeability in dependence of disease activity. The aim of our study was to measure small bowel permeability in first-degree relatives of the patients with Crohn's disease. In 14 first-degree relatives of Crohn's disease patients (7 men, 7 women) there was measured small permeability using lactulose, mannitol and D-xylose. Sugars were investigated in 5 hour collected urine and examined using capillary gas chromatography. The absorption of all the...

[Pitfalls in the diagnosis of infectious endocarditis].

J Schildberger, T Brychta, J Manousek, P Jerábek, B Semrád

Vnitr Lek 2001, 47(6):375-380

A group of 63 patients with infectious endocarditis (IE) (1991-1998) was subjected to a detailed retrospective analysis. The authors investigated the age of the patients, site of IE, type of infectious agent, incidence of coinciding diseases or interventions in the close premorbid period of IE, size of vegetation, incidence of embilizations, heart failure, indications for vital early cardiosurgery, number of deaths. From the clinical analysis it may be concluded: 1. There is a new group of patients with IE, who before development of the disease have no manifest cardiac disease who however frequently suffer from another coinciding disease; 2. There...

[Apoptosis, its mechanisms and medical significance. I. Definition of apoptosis and its progression at the cellular level].

J Novosad, K Kodydková, J Krejsek

Vnitr Lek 2001, 47(6):381-386

Apoptosis is a one example of genetically-regulated cell death. It is characterized by the phylogenetically highly conserved activation of specific genes and proteins followed by energy-consuming proteolytic autodestruction. Apoptosis seems to be physiological and highly selective mechanism to eliminate either old or injured cells in organisms. It is in contrary to mitosis. A highly complex combination of various stimuli both extracellular and intracellular origins is required for induction of apoptosis together with preserved oxidative phosphorylation.

[Apoptosis, its mechanisms and medical significance. II. Disorders of apoptosis regulation and their relation to the development of diseases].

J Novosad, K Kodydková, J Krejsek

Vnitr Lek 2001, 47(6):387-390

Study of apoptosis seems to be relevant to clinical medicine nowadays. Dysregulation of apoptosis is under the certain circumstances the cause of various pathological processes in organism. The numerous methods to analyse apoptosis are now well established. It is very likely that our better understanding of apoptosis could lead to improvement in diagnosis and treatment of diseases such as immunopathology, cancer, and others.

[Non-thrombotic pulmonary embolisms].

M Riedel

Vnitr Lek 2001, 47(6):391-396

In the absence of intracardiac or intrapulmonary shunts, the pulmonary microvasculature traps all embolized particles greater than 10 microns. In the vast majority of cases these emboli are venous thrombi which lodge in larger pulmonary arteries, resulting in obstructive phenomena rather than primarily being injurious to lung parenchyma. This review deals exclusively with nonthrombotic pulmonary embolism which involves substances that lodge predominantly in the pulmonary microvessels and cause a true endothelial and parenchymal injury, as well as obstructive phenomena. The article focuses on fat embolism, amniotic fluid embolism, gas embolism, septic...

[Endoscopic findings and clinical diagnosis in gastroenterology].

Z Maratka

Vnitr Lek 2001, 47(6):397-399

[Diagnosis and therapy of anemia in chronic diseases].

V Scudla, Z Adam, M Scudlová

Vnitr Lek 2001, 47(6):400-406

The article deals with contemporary views on anaemia associated with chronic diseases. The authors present the definition of this nosological unit, draw attention to its high incidence in clinical practice and fact that it is frequently mistaken for iron deficiency anaemia. The authors submit a review of the most frequent diseases which cause the development of this type of anaemia and analyze the role of activation of the system of cellular immunity, the monocyte-macrophage system, agents of the cytokine network in inhibition of proliferation and differentiation of erythroid precursors, reduced production of endogenous erythropoietin with a reduced...

[Electrocardiographic changes in patients with acute pancreatitis. Case report and review of the literature].

A Bulava, M Skvarilová, O Marek, J Lukl

Vnitr Lek 2001, 47(6):407-410

Transient electrocardiographic changes in patients with acute pancreatitis are well known in the literature. Mostly these changes are in the form of T-wave inversion, ST-segment depression, and rarely ST-segment elevation without the presence of coronary artery disease. We report a patient, in whom electrocardiographic changes mimicked acute inferior myocardial infarction with subsequent evolution of Q-waves in the inferior leads and ischaemia in the anterior wall. To the authors' knowledge, this is the first report documenting the evolution of Q-waves on surface ECG in the absence of myocardial necrosis verified by postmortem examination in the patient,...

[Transcatheter embolization of a coronary fistula in the treatment of ischemic heart disease].

J Veselka, D Tesar, T Urbanová

Vnitr Lek 2001, 47(6):411-413

The authors present the case of a 71-year-old female patient with clinical signs of ischaemic heart disease where they diagnosed a coronary fistula between the ramus interventricularis anterior and the trunk of the pulmonary artery. Because of the marked symptomatology they made a transcatheter embolisation of the fistula by introduction of embolisation spirals which led to the elimination of ischaemic symptomatology. Because of the unusual character, pretentious technical aspects and possible risks this operation is indicated only in adult symptomatic patients.

[Just what is an internist? Introduction to a discussion topic of EFIM (European Federation of Internal Medicine)].

K Horky

Vnitr Lek 2001, 47(6):414

Just what is an internist? An identikit of the specialist in the diseases of adults composed of six thumbnail definitions.

Vnitr Lek 2001, 47(6):414-417