[The truth about devitalization].

M Hájek

Vnitr Lek 2002, 48(3):175-176

[TT virus infection in liver transplant recipients with cryptogennic cirrhosis].

R Horváth, P Studeník, J Benedík, M Dendis, J Cerný

Vnitr Lek 2002, 48(3):177-181

The possible causative role of novel TT virus in liver diseases has been intensively studied in regarding its hepatotrophy, ability to cause persistent infection and worldwide prevalence. The aim of this study was to estimate the prevalence as well as the clinical importance of TTV in a normal healthy population group in the Czech Republic and in a group of liver transplant recipients diagnosed with cryptogenic cirrhosis. Polymerase chain reaction (PCR) detected the DNA of TT virus in 68% (13/19) of samples isolated from peripheral blood leukocytes and in 21% (4/19) of plasma samples in the liver transplant group. The viral DNA was detected only in...

[Pharmacotherapy of chronic obstructive pulmonary disease in patients with indications for long-term home oxygen therapy].

E Rozborilová, R Vysehradský, P Strapko, K Krivcíková

Vnitr Lek 2002, 48(3):182-184

The authors submit a cross-sectional analysis of out-patient pharmacotherapy of chronic obstructive lung disease in 138 patients where long-term home oxygen therapy was indicated. To this group of patients no inhalatory bronchodilatating drugs were administered in 19.6% of the patients! The authors provide evidence of a non-significant better survival of patients who used inhalatory bronchodilatating drugs. From the mentioned group during the follow up period 41 (29.7%) died with a mean survival of 16.5 +/- 11.9 (0-39) months. Based on the mentioned results the authors draw attention to the relatively late indication of long-term home oxygen therapy...

[Potential predictors of therapeutic response in patients with cryptogenic fibrosing alveolitis].

R Vysehradský, E Rozborilová, J Straková, H Polácek, Z Huťka

Vnitr Lek 2002, 48(3):185-191

The authors present a clinical observation with the objective to test which objective indicators make it possible to predict the effect of treatment in patients with cryptogenic fibrotizing alveolitis. Retrospective analysis of the documentation of a longitudinal follow up of 34 patients with this diagnosis revealed that the presence of fibroproliferative changes on the high resolution CT image predicts significantly the absence of a therapeutic effect and conversely the absence of such changes predisposes for significant improvement of pulmonary functions during treatment. They found also a significant correlation between he ratio of lymphocytes in...

[Hyperinsulinemia and disorders of the menstrual cycle].

I Dravecká, I Lazúrová, V Kraus, J Petrovicová, M Paĺko

Vnitr Lek 2002, 48(3):192-196

Hyperinsulinaemia and insulin resistance are usually associated phenomena of obesity and the polycystic ovary syndrome (PCO syndrome). On the other hand the PCO syndrome and obesity are often associated with disorders of the menstrual cycle and/or sterility. The authors examined 35 women aged 21 to 38 years (x = 27 +/- 4.4) with a history of anovulation cycles and/or sterility. 24 of them (68.6%) suffered from PCO syndrome. Their mean BMI was 28.95 kg/m2. 11 patients had a normal body weight, 6 were overweight and 18 were obese. The authors used the oral glucose tolerance test (oGTT) and during minute 0 and 120 blood samples were collected for assessment...

[Importance of determination of lymphocytes in intestinal mucosa biopsy specimens using flow cytometry in the evaluation of ulcerative colitis activity].

J Polko, M Vrlík, J Petrisková, J Straková, M Mokán

Vnitr Lek 2002, 48(3):197-201

In this clinical study, we have examined 10 patients with ulcerative colitis. The study group included 5 men and 5 women. The control group consisted of 6 patients with negative colonoscopic finding performed for differential diagnosis of the dyspeptic syndrome. Patients with ulcerative colitis were divided into two groups according to the clinical pattern, macroscopic endoscopic finding, and histological examination of the bioptic specimens. The Ist group of patients with active stage of ulcerative colitis, the IInd group of patients in remission, without clinical and endoscopic signs of disease activity. We have found that from the followed markers...

[Determination of the end-point of the radiofrequency linear lesion in the subeustachian isthmus and its relation to treatment of atrial flutter and fibrillation. Acute and long-term results in 90 patients].

M Fiala, P Heinc, J Lukl

Vnitr Lek 2002, 48(3):202-209

UNLABELLED: Complete subeustachian isthmus (isthmus) block created with radiofrequency (RF) linear lesion eliminates type I. atrial flutter (AFL). The end-point of the procedure is measurable.PATIENTS AND METHOD: Ninety patients (21 F) aged 57.6 +/- 12.5 years underwent RF catheter ablation for AFL. Twenty patients had significant structural heart disease (SHD). Atrial fibrillation (AF) was previously documented in 34 (37.8%) patients. Complete isthmus block served as the end-point of the procedure.RESULTS: Following the first ablation procedure complete isthmus block was achieved in 81 (90%) patients and incomplete isthmus block in 7 (7.8%)...

[Sonographic study of the diameter of the inferior vena cava for optimal ultrafiltration in hemodialysis].

O Remes, S Sulková

Vnitr Lek 2002, 48(3):210-215

The objective of the work was to evaluate the results of sonographic examination of the diameter of the vena cava inferior (VCI) as a parameter of hydratation of haemodialyzed patients. In a group of 84 haemodialyzed patients, mean age 66.32 years, the collapsibility index of the IVC was measure. The collapsibility index (CI) was calculated according to the formula: [formula: see text] where IVCexp = the maximum diameter of the IVC in maximum inspiration. Values of the index within the range from 40-75% corresponded to normal hydratation. The results were compared with ultrafiltration (total and expressed as % of body weight after haemodialyzation),...

[Quality of life and tolerance of maintenance therapy in patients with multiple myeloma].

Z Adam, L Pour, A Svobodník, V Scudla, F Salajka, M Vytrasová, J Bacovský, M Schützová, V Koza, E Sumná, H Franková, F Lehanka, J Gumulec, Y Stavarová, S Cahová, M Vránová, V Dostálová, P Kessler, L Walterová, I Meluzínová, N Seifertová, O Sláma, T Büchler, M Krejcí, V Bencíková, V Nykodýmová, L Dusek, R Hájek,

Vnitr Lek 2002, 48(3):216-229

Questionnaires on the quality of life and tolerance of different parts of maintenance treatment were sent to a total of 83 patients with multiple myeloma. All patients were for more than one year on maintenance treatment which involved either interferon alpha monotherapy (I), 3 million u. three times per week till signs of relapse developed or sequence administration of interferon alpha and dexamethazone 40 mg on day 1 to 4, 10 to 13 and 20 to 23 and then after a four-week interval again interferon alpha, again till progression of the disease occurred. The patients evaluated the presence or absence of different undesirable effects of treatment during...

[New views on the treatment of chronic myelocytic leukemia. Literature review].

E Tóthová

Vnitr Lek 2002, 48(3):230-233

The expansion of knowledge of molecular biology and pathophysiology of chronic myeloid leukaemia (CML) indicate a new therapeutic approaches of the disease. Besides less toxic nonmyeloablative regimes of allogenEic transplantation and the introduction of modified interpherone regimes attracts our interest therapy more specific, aimed to a primary reason of a disease, BCR/ABL gene, and its products, that are responsible for leukaemic transformation. The paper is a summary of experimental, as well as first clinical experiences with application of thyrosinkinase-inhibitors, farnesyl-transferase-inhibitors and vaccination therapy of CML. Even thought is...

[Sudden cardiac death (part 2)].

M Pleskot, J Kajzr, P Parízek, M Mesťan

Vnitr Lek 2002, 48(3):234-240

In addition to acute treatment of sudden cardiac death the authors focus attention in particular on an analysis of long-term diagnostic and therapeutic provisions to cope with this serious clinical condition. The basic therapeutic procedures include influencing of the arrythmogenic substrate and modulating factors associated with the development of tachyarrhythmias by revascularization of the myocardium and radiofrequency ablation; as to drugs in particular by administration of angiotensin converting enzyme inhibitors and in rare instances by the application of other surgical methods. Haemodynamically important ventricular arrhythmias are treated by...

[Determination of blood pressure sensitivity to salt].

J Veselý

Vnitr Lek 2002, 48(3):241-247

Considerable evidence has accumulated indicating that sodium sensitivity of blood pressure is an important prognostic factor in hypertension. This review article focuses on methods used to define salt sensitivity in man. The linear approximation of pressure-natriuresis curve has made it possible to elaborate reliable non-invasive approaches for distinguishing salt-sensitive from salt-resistant forms of human hypertension. The sodium sensitivity index, calculated as the ratio of the change in mean arterial pressure over the change in natriuresis, can be calculated to characterize hypertension. Literary data show that salt sensitivity increases with...

[Prevention of mycotic infections in oncology patients with regard to the toxicity of antimycotic agents].

M Doubek, J Mayer, D Horký, J Doubek, Z Rácil, J Vorlícek

Vnitr Lek 2002, 48(3):248-254

Profound and prolonged neutropenia following chemotherapy is a major risk factor for systemic fungal infections. It is still unclear how effective the various measures that are currently being used are in preventing serious fungal infection. Although a number of studies have been published on antifungal prophylaxis in neutropenic patients, there are a lot of conflicting data. At the present time, it seems that antifungal prophylaxis is more a matter of faith rather than science. The prophylactic use of fluconazole or itraconazole may reduce the incidence of systemic fungal infections in high-risk patient groups, mainly in patients with haematological...

[The Brugada syndrome].

A Mádle, Z Kratochvíl, A Polívková

Vnitr Lek 2002, 48(3):255-258

On the case of a patient who had medical care on account of a febrile disease diagnosed as pleuritis the authors draw attention to a relatively new pathological unit described as the "Brugada syndrome". It is a genetically conditioned anomaly of sodium channels, which, when fully expressed, is manifested by a picture resembling right bundle branch block, elevation of ST segment in leads V1-V3 and the occurrence of malignant ventricular arrhythmias or sudden death without structural heart disease. Neither the reported patient nor his family suffered from arrhythmias. The authors present however a typical electrocardiographic picture ad positive test...

[Richter's syndrome (bimorphologic malignant lymphoma)].

D Holománová, A Varga, M Mistrík, A Sakalová, P Kotoucek, L Plank, P Szépe

Vnitr Lek 2002, 48(3):259-263

Two distinct morphological types of malignant lymphoma in the same patient occur mostly due to transformation of a low grade lymphoma (CLL) into a large--cell non-Hodgkin lymphoma (high-grade lymphoma). Later reports have brough evidence of a clonal relationship between CLL and supervening NHL. The Richter's syndrome was found to be more frequent in patients with CLL displaying either multiple chromosomal aberrations or monoclonal gammapaties. In the last two decades reports have evidenced the existence of two types of the Richter's syndrome: one, the "classical" as a terminal event in a long evolving CLL, the other "variant" as the first clinical...