Autoimunitný polyglandulárny syndróm - editorial

K. Vondra, V. Zamrazil

Vnitr Lek 2010, 56(11):1111-1113  

Lymfomu podobný průběh agresivní multisystémové histiocytózy z Langerhansových buněk - editorial

K. Veselý

Vnitr Lek 2010, 56(11):1114-1115  

A different view of acute upper gastrointestinal bleeding in liver cirrhosis patients

P. Svoboda, J. Ehrmann, P. Klvaňa, E. Machytka, M. Rydlo, V. Hrabovský

Vnitr Lek 2010, 56(11):1116-1121  

Objectives:The study focuses predominantly on non-varicose sources of acute upper gastrointestinal bleeding in liver cirrhosis patients and aims to determine its mortality. Methods and subjects:The prospective examination included 137 liver cirrhosis patients with acute upper GIT bleeding. All the patients underwent an endoscopic examination. In case of multiple findings, defining the bleeding source was based on the specialist's attitude presented as the conclusion of the endoscopic examination. Results:The most frequent causes of acute bleeding included oesophagus varices (57.7%), followed by peptic gastric...

Risk stratification by cardiac gated SPECT combined with coronary artery calcium score in patients with diabetes mellitus and/or renal failure

I. Metelková, M. Kamínek, E. Sovová, M. Hutyra, M. Budíková, E. Buriánková, R. Formánek, L. Henzlová, R. Metelka

Vnitr Lek 2010, 56(11):1122-1129  

Aim:The aim of this study was to evaluate added value of coronary artery calcium score (CAC) measurement as an adjunct to cardiac gated SPECT for risk stratification in population of patients with diabetes mellitus (DM) and/or chronic renal failure on hemodialysis (CHRF-HD). Methods:Retrospective analysis of 67 patients, who were referred for stress gated myocardial perfusion SPECT and CAC. Characteristics of study population: 40 men, mean age 59 ± 12 years, DM (n = 28), CHRF-HD (n = 22), DM and CHRF-HD simultaneously (n = 17). Perfusion summed stress and different scores (SSS, SDS), the left ventricle ejection fraction...

Determination of the progression of prostate cancer using RT-PCR method

A. Zummerová, M. Blaško, D. Böhmer, J. Filo, P. Kováč, V. Repiská

Vnitr Lek 2010, 56(11):1130-1137  

The aim of our studywas to verify possible utilization of RT-PCR method (Reverse Transcriptase-Polymerase Chain Reaction) as a diagnostic and prognostic modality of the progression of prostate cancer. This approach is commonly used for the detection of circulating carcinomatous cells in peripheral blood of patients with malignant breast tumors, and our ambition was to adopt this method for patients with prostate cancer. The contribution of this method consists in its ability to detect early stages of the dispersion of carcinomatous cells, so called micrometastases, in the peripheral circulation of patients. The estimation of the progression...

Doporučený postup pro diagnostiku a léčbu chronické obstrukční plicní nemoci (CHOPN) - stabilní fáze

J. Musil, F. Salajka, S. Kos

Vnitr Lek 2010, 56(11):1150-1154  

Angiotensin converting enzyme inhibitors and angiotensin II receptor blockers in atrial fibrillation

M. J. Levine, P. Schweitzer

Vnitr Lek 2010, 56(11):1138-1141  

Atrial fibrillation is the most prevalent clinically relevant arrhythmia; a major cause of morbidity and hospitalization. Additionally, atrial fibrillation carries a significant risk of thrombo-embolic events, specifically cerebrovascular accident. Among the most prevalent risk factors for atrial fibrillation, hypertension not only has the strongest correlation but is also the most prevalent. The renin-angiotensin-aldosterone system represents a prime target for the treatment of hypertension through the use of angiotensin-converting enzymes inhibitors and angiotensin II receptor blockers. In addition to blood pressure control, these medications have...

Osteoporosis in chronic obstructive pulmonary disease

P. Pobeha, I. Lazúrová, R. Tkáčová

Vnitr Lek 2010, 56(11):1142-1149  

Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of osteoporosis because of their age, limited physical activity, low body mass index, smoking, hypogonadism, malnutrition, and use of corticosteroids. Systemic inflammation represents an additional pathomechanism contributing to the development of osteoporosis in COPD patients. Males in their mid to late 60s with a smoking history of greater than 60 pack-years have a prevalence rate of vertebral fractures similar to, and possibly greater than, postmenopausal women greater than or equal to 65 years old: in patients with severe COPD, up to 50-70% have osteoporosis or osteopenia,...

Metastatic involvement of the heart and pericardium - MR case reports

J. Mištinová, A. Jurko, A. Hruboň, G. Kaliská

Vnitr Lek 2010, 56(11):1155-1157  

Secondary metastatic tumors of the heart and pericardium are in comparison with primary cardiac tumors more common, but their overall prognosis is very poor. Metastases can occur in every part of the heart and pericardium. The most common source are tumors - lung cancer, breast cancer, melanoma and lymphoma. In this case report we described two patients with metastatic involvement of the heart. We are pointing out the possibilities of diagnostic imaging of cardiac tumors using echocardiography and magnetic resonance.

Diffuse plane normolipemic xanthomatosis and necrobiotic xanthogranuloma associated with monoclonal gammopathy - determining the disease stage with PET-CT and treatment experience. Two case studies and literature review

Z. Adam, L. Zahradová, M. Krejčí, L. Pour, R. Koukalová, Z. Řehák, J. Feit, L. Křen, M. Mechl, V. Vašků, A. Sirotková, R. Hájek, J. Mayer

Vnitr Lek 2010, 56(11):1158-1168  

Monoclonal gammopathy may manifest itself through a range of skin disorders, including plane normolipemic xanthoma and necrobiotic xanthogranuloma. The present paper describes two patients with these cutaneous symptoms. The first has extensive areas of skin affected by flat xanthomas, monoclonal gammopathy with > 10% infiltration of bone marrow with clonal plasmocytes and, according to PET-CT, unclear lymphadenopathy in the retroperitoneal area. The size of this lymphadenopathy (histologically no malignant infiltration and no confirmed infectious aetiology) has not changed significantly over a 4-year follow-up. Repeated PET-CT scans...

Autoimmune polyendocrine syndrome type 2 associated with autoimmune hypophysitis and coeliac disease

K. Hrubišková, P. Jackuliak, P. Vaňuga, M. Pura, J. Payer

Vnitr Lek 2010, 56(11):1169-1176  

Autoimmune polyendocrine syndromes (APS) are organ-specific autoimmune disorders affecting multiple endocrine glands; these are gradually destroyed by action of autoantibodies. Similarly to other autoimmune diseases, the presence of certain genetic predisposition is an essential prerequisite to the disease development; polymorphism of the main histocompatible system (HLA in humans) appears to play the most important role. APS are categorized into four types, based on what combination of endocrine glands is affected. APS type 1, characterised by hypoparathyreosis, mucocutaneous candidiasis and Addison's disease, is frequently seen in childhood. For...

Lymphoma-like course in aggressive adult multisystem Langerhans cell histiocytosis and the benefit of PET/CT imaging in evaluation of diffuse metabolic activity of lung parenchyma

P. Szturz, Z. Adam, Z. Řehák, R. Koukalová, R. Kodet, T. Nebeský, J. Neubauer, M. Moulis, L. Šmardová, J. Mayer

Vnitr Lek 2010, 56(11):1177-1193  

The case report given here describes an unusual case of a 35-year-old otherwise healthy male diagnosed with aggressive form of Langerhans cell histiocytosis initially taking course under the form of lymphoma with expressed B symptoms (night sweats, fever and weight loss) and generalized peripheral lymphadenopathy. Also present were productive cough and perianal itching. The diagnosis was determined from lymph node and perianal skin biopsies. Furthermore, by a typical finding on HRCT (high-resolution computed tomography), pulmonary involvement was confirmed the gradual development of which we succeeded to document through a series of several HRCT and...

Central hemiparesis as manifestation of systemic vasculitis

Ľ. Cibičková, T. Soukup, J. Tomš, L. Klzo, Abuhajar Mohamed Abdalla, P. Bradna

Vnitr Lek 2010, 56(11):1194-1197  

We present a case report of patient with systemic vasculitis with affection of heart, skin, gastrointestinal tract and rare involvement of central nervous system. Diagnosis of systemic vasculitis was based on clinical manifestations, blood hypereosinophilia and brain magnetic resonance imaging. Immunosuppressive therapy led to regression of symptoms including initially present neurologic manifestation.

Professor Frantisek Por MD and Professor Robert Klopstock MD, students at Budapest and Prague Faculties of Medicine

M. Mydlík, K. Derzsiová

Vnitr Lek 2010, 56(11):1198-1200  

Professor Frantisek Por MD and Professor Robert Klopstock MD were contemporaries, both born in 1899, one in Zvolen, the other in Dombovar, at the time of Austro-Hungarian Monarchy. Prof. Por attended the Faculty of Medicine in Budapest from 1918 to 1920, and Prof. Klopstock studied at the same place between 1917 and 1919. From 1920 until graduation on 6th February 1926, Prof. Por continued his studies at the German Faculty of Medicine, Charles University in Prague. Prof. Klopstock had to interrupt his studies in Budapest due to pulmonary tuberculosis; he received treatment at Tatranske Matliare where he befriended Franz Kafka. Later, upon Kafka's encouragement,...

Pokroky ve výzkumu aterosklerózy

M. Berková

Vnitr Lek 2010, 56(11):1201-1202