[Transesophageal and transthoracic echocardiography--their diagnostic contributions].

G Kamenský, N Plevová, F Slavícek

Vnitr Lek 1991, 37(9-10):729-739

Of 815 patients referred for echocardiographic examination 77 were examined also by the transoesophageal route. The most frequent reason were pathological processes where standard echocardiography provides relatively limited information as well as technically inadequate transthoracic examinations, if the echogenicity of the patient is low. The reasons for examination were complications of myocardial infarctions, a cardiac source of embolization bacterial endocarditis, congenital heart defects, cardiac formations, aortal disease and comatose conditions. Transthoracic echocardiography was positive in 25 cases (32.4%), transoesophageal echocardiography...

[Testing the effectiveness of drug therapy in supraventricular dysrhythmias using diagnostic esophageal cardiac stimulation].

R Stípal, T Minarík, A Martínek

Vnitr Lek 1991, 37(9-10):740-744

The authors examined 33 patients aged 59.9 years with a new atrial fibrillation and 18 patients aged 45.6 years with attacks of supraventricular tachycardia. After medicamentous change to a sinus rhythm (in fibrillation after digoxin and verapamil i.v. and in supraventricular tachycardia after verapamil i.v.) the patients were changed to oral antiarrhythmic drugs. The method of diagnostic oesophageal stimulation was used after saturation with the oral form to test the effectiveness of long-term treatment. In the author's opinion the basic drug in atrial fibrillation is digoxin, possibly combined with verapamil or quinidine. In supraventricular tachycardia...

[Functional cardiovascular disorders in patients with neuroses at rest and during physical loading].

S Juhás, J Mechír, J Kafka, V Baldovský, V Ulicianský

Vnitr Lek 1991, 37(9-10):745-751

The authors examined using selected non-invasive cardiological examination methods 33 patients with neurosis. Four were eliminated on account of organic heart disease. From the group of 29 patients 12 had ECG changes (41%)--of those 5 (17%) had an incomplete right bundle branch block and 1 (3%) had a left anterior fascicular block; 2 (7%) had the syndrome of early repolarization and 4 (14%) had changes of the T wave. The polycardiogram did not reveal a statistically significant difference in the investigated indicators (PEPc, LVETc, WI, PVR) between the group of sick and healthy patients at rest. Ambulatory 24-hour monitoring of the ECG was done in...

[Blood pressure and insulin resistance in type 2 diabetics].

J Válek, L Karasová, T Pelikánová, T Sosna, J Skibová

Vnitr Lek 1991, 37(9-10):752-760

The authors analyzed in 145 patients with Type 2, diabetes, persisting on average for 10 years, influences affecting the blood pressure reading. 1. In patients treated on account of hypertension (40%) the increase of systolic and diastolic pressure persisted and the fasting concentrations of C peptide were elevated. 2. In patients with elevated levels of diastolic blood pressure and C peptide the rate of cerebrovascular attacks in direct relatives was higher. 3. Higher blood pressure readings were associated with a higher C peptide concentration, signs of ischaemia on the ECG tracing and left ventricular hypertrophy respectively. 4. The higher blood...

[Multicenter study with gliquidone in type 2 diabetes mellitus].

A Kreze, J Vozár, P Rázus, A Lacko, Z Málek, Z Putz

Vnitr Lek 1991, 37(9-10):761-767

The effectiveness and tolerance of the new sulphonyl urea antidiabetic gliquidone (commercial name Glurenorm) was tested by three-month administration of this preparation in a group of 39 type 2 diabetics. Gliquidone proved a medium-strength beta-cytotropic antidiabetic preparation. As to side-effects, the authors noted only dyspepsia in one patient (2.5%). Symptomatic hypoglycaemia did not develop in any of the patients. In the subgroup of six patients with diabetic nephropathy the indicators of renal functions did not deteriorate. In a sub-group of 6 patients with concurrent hepatopathy the originally elevated gamma-glutamyl transpeptidase activity...

[Chronic active surface-positive Campylobacter antrum gastritis-- morphological changes 1 year after treatment with bismuth].

M Sorf, V Krislo, M Gogora

Vnitr Lek 1991, 37(9-10):768-771

The works is based on a previous investigation published in the journal Vnitrní Lékarství, 36, 1990, 8, pp. 759-762. The authors investigated morphological changes of the gastric mucosa and the presence of Campylobacter pylori (CP) in probands with chronic active surface CP positive antrum gastritis one year after treatment with a bismuth preparation (Bismuth citrate 120 mg per capsule made on prescription) for a one-month period 4 capsules per day. This concerned probands with functional dyspepsia without a history of alcohol intake. After a one-year interval eradication of CP persisted in 8 probands (53.3%); in 7 patients (46.7%) there was a relapse...

[Helicobacter pylori after proximal selective vagotomy].

P Svoboda, A Krpenský, H Münzová, M Kunovská

Vnitr Lek 1991, 37(9-10):772-775

The authors examined histologically in 40 patients after proximal selective vagotomy on account of duodenal ulceration specimens of the antral mucosa for the presence of Helicobacter pylori. The latter was detected in 38 (95%) patients. The intensity of colonization evaluated semiquantitatively was not directly related to the dyspeptic complaints. No relapses of ulcers were observed and the author's experience does not confirm the theory of a direct part played by Helicobacter in the manifestation of duodenal ulceration in patients after proximal selective vagotomy.

[HLA-B27 in the families of probands with arthritis after acute respiratory tract disease].

L Hrncírová, L Klabusay, V Vitulová

Vnitr Lek 1991, 37(9-10):776-780

HLA B27 antigen was found in 10/25 patients with arthritis after acute respiratory disease (ARD) and in 21/75 direct relatives of 23 of these probands, where a genealogical investigation could be made. With regard to the 9.5% incidence of HLA B27 in the Czech population this implies a positive association in patients (RR = 6.35) and direct relatives (R = 3.70). In the sub-group of HLA B27 positive probands HLA B27 positivity was found in 19/27 (70.4%) of direct relatives (RR = 22.6). In one female relative a recurrent monoarthritis of the talo-crural joint was found, the remainder did not suffer from inflammatory changes of the joints. The revealed...

[Relation of HLA antigens to prognosis in Hodgkin's disease].

J Prazák, P Chytrý, Z Hermanská

Vnitr Lek 1991, 37(9-10):781-788

The prognostic value of HLA antigens in Hodgkin's disease was assessed by multivariate regression analyses. A significantly adverse prognostic impact for achieving complete remission by primary treatment and for its persistence was proved in four antigens locus B (B18, B5, B27 and B15). Five-year survival without signs of the disease, i.e. survival without relapse is significantly lower in subjects with antigen B5, as compared with the group of patients where the antigen was not detected (42% vs. 58%, p = 0.05). An independent prognostic impact of the selected HLA antigens was confirmed in models incl. also formerly tested risk factors for the relapse...

[The effect of ethanol on increased expression of HLA-A,-B antigens on lymphocytes].

A Májský

Vnitr Lek 1991, 37(9-10):789-794

Ethanol in a concentration of 0.001% to 2% increases the expressivity of HLA-A, B antigens on lymphocytes. In 26.13% of the examinations HLA antigens were proved only on lymphocytes processed with ethanol. The expressivity is maximally enhanced already by short-term incubation of lymphocytes with ethanol; if prolonged to 120 mins at 20 degrees C ethanol does not produce an unspecific positivity of results. There is no difference between processing of lymphocytes at 20 degrees C and 37 degrees C. 1% and 2% ethanol facilitates detection of HLA-A, B antigens after addition to serum and lymphocytes in the first stage of the microlymphocytotoxic test.

[An unusual expression of cALL antigen on blast cells in a patient with acute myelomonocytic leukemia].

J Krejsek, O Kopecký, B Fixa, L Jebavý, M Pecka

Vnitr Lek 1991, 37(9-10):795-799

The authors describe a case of myeloid leukemia of the myelomonocytic type (M4, FAB 1976) where blastic cells bear the lymphoblastic cALL sign. These cases of the so-called hybrid phenotype of acute leukemia are rare. The importance of the hybrid phenotype for the course and prognosis of the disease is not known.

[Candida myocarditis and polymyositis in acute lymphoblastic leukemia].

M Resl, L Jebavý, M Otcenásek

Vnitr Lek 1991, 37(9-10):800-804

Candida sepsis in 18-year-old man with acute lymphoblastic leukemia was associated with multisystem alteration accentuated in cardiac and skeletal muscles. Candida tropicalis identified in the post-mortem blood culture was resistant to azole-chemotherapeutics and semi-sensitive to polyene-antibiotics. Unusual myocardial involvement and a role of Candida spp. during opportune infections in immunosuppressed patients are discussed.

[Perispondylitis psoriatica].

M Lindusková, J Beran

Vnitr Lek 1991, 37(9-10):805-809

In their brief paper the authors draw attention to the rapid development of morphological changes on the axial skeleton in a patient with psoriasis vulgaris. They give a brief account of the classification of spinal and paraspinal ossifications in seronegative spondarthritis, spondyloses and other spondylopathies. The described case-history pertains to a paraspinal ossification and the authors try to explain why they assume that the term "Perispondylitis psoriatica" is quite justified.

[Biological aspects of paraneoplastic syndromes].

P Opat

Vnitr Lek 1991, 37(9-10):810-812

The author discusses some aspects of indirect manifestations of tumourous diseases, i.e. paraneoplastic syndromes. The already known paraendocrine hormone secretion by tumours is supplemented by recent knowledge from the biology of tumourous diseases incl. indirect manifestations where an important part is played by autocrine secretion of regulatory, mainly growth factors.

[How shall we treat ventricular arrhythmias?].

Z Rosol

Vnitr Lek 1991, 37(9-10):829-832