Vnitřní lékařství, 1992 (roč. 38), číslo 7
[Changes in hemostasis in persons exposed to a change in atmospheric pressure].
M Emmerová, J Dvorák, M Hadravský, M Krátký, J Větrovcová, E Berková
Vnitr Lek 1992, 38(7):625-631
In eight healthy volunteers--four professional and four amateur divers--in a hyperbaric chamber simulated diving was implemented, corresponding to the most frequently encountered conditions of diving activities in Czechoslovakia. Throughout the trial indicators of haemostasis were investigated. Under the selected model conditions changes of the investigated parameters developed which can be considered indicators of a latent process of disseminated coagulation and the so-called syndrome of silent bubbles.
[Air embolism].
V Dolezal, J Fialka
Vnitr Lek 1992, 38(7):632-639
Air embolism is a dramatic event which threatens the patient's life during invasive therapeutic and diagnostic procedures. Immediately after establishment of the diagnosis treatment in a hyperbaric chamber should be started. The prognosis depends to a certain extent on how quickly the patient is transferred into a hyperbaric chamber. Treatment with hyperbaric oxygen is based on fundamental physical and physiological principles of the action of compressed air and the supply of a large amount of oxygen in a dissolved form into the ischaemic tissue beyond the obstruction. Installation of hyperbaric chambers in hospitals would make successful and prompt...
[Hyperbaric oxygenation in the treatment of necrotizing fasciitis].
Z Krásová, A Matusek, D Chmelar
Vnitr Lek 1992, 38(7):640-644
The authors present the results of treatment provided to 11 patients with necrotizing fasciitis who were after a surgical operation and after administration of antibiotics treated in a hyperbaric chamber. A total of 8 patients (82%) recovered completely. The authors discuss the theory of action of hyperbaric oxygen on microorganisms and draw attention to the possible reduction of mortality of this serious disease when using hyperbaric oxygenation. The latter is considered an important auxiliary method which supplements surgical treatment, rational antibiotic therapy and in particular careful intensive care.
[Treatment of ischemic cerebrovascular accidents with hyperbaric oxygenation].
J Berger, M Emmerová, M Hadravský, M Krátký, J Větrovcová, E Berková
Vnitr Lek 1992, 38(7):645-650
The authors present eleven year's experience with comprehensive treatment of patients who suffered an ischemic cerebrovascular attack. This comprises so-called conventional treatment of cerebrovascular attacks and also hyperbaroxia, i.e. administration of oxygen under high partial pressure. The authors used a therapeutic pressure of 0.2 MPa for 90 minutes in individual exposures. Of 31 treated patients 23 improved, i.e. 76%; eight improved slightly, eight significantly and seven substantially. The condition of the remainder did not change. Hyperbaroxia should therefore be used everywhere where this method is available.
[Estimation of energy utilization in patients based on catabolism of endogenous proteins].
J Steinigerová, J Pávek
Vnitr Lek 1992, 38(7):651-657
The authors describe their own methodical procedure used for estimation of energy requirements of patients with a defined nutrition. They ascribe importance to the quantitative assessment of the degree of catabolism of endogenous proteins the value of which they transform mathematically to calculate the catabolic factor with which they multiply the basal energy output calculated according to Harris-Benedict equations. At the same time they take into account also the thermogenic action of nutrients. In 28 patients with gastroenterological diseases they confronted their own procedure with indirect calorimetry and theoretical calculations using Jabor's...
[Hemodynamic effects of nitroglycerin and trimepranol in acute myocardial infarct].
J Charvát, K Hlavácek
Vnitr Lek 1992, 38(7):658-663
The authors investigated the effect of intravenous nitroglycerin and trimepranol on the haemodynamics of patients with acute myocardial infarction. They found that nitroglycerin has a favourable effect on haemodynamics as it leads to a reduction of the pressure in the wedged pulmonary artery and to a reduction of oxygen requirement of the cardiac muscle, while the changes of the minute volume and pulse rate are insignificant. Trimepranol leads to a rise of pressure in the wedged pulmonary artery, sometimes to critical values, and to a decline of the cardiac minute output. The authors conclude that trimepranol is suitable for a selected group of patients...
[Rapid continuous stimulation of the atrium (overdrive) in the treatment of refractory supraventricular tachycardia].
B Stancák, J Pella, J Resetár, J Bodnár, M Palinský
Vnitr Lek 1992, 38(7):664-671
In 71 patients, divided into four groups by the type of supraventricular tachycardia (SVT) during electrophysiological examination, 918 stimulations were implemented by the method of rapid continuous stimulation of the atria (overdrive) in order to interfere with a SVT paroxysm. In addition to characteristics of tachycardia the authors evaluated parameters of overdrive stimulation, i.e. the duration of the stimulation cycle (CL STIM), the ratio CL STIM/CL SVT, the number of stimuli required to terminate tachycardia (N STIM) and their mutual relations. In the group of atrioventricular reciprocal tachycardias (WPW, n = 17) the effectiveness was 50.4%,...
[Hypercalciuria].
J Kocián
Vnitr Lek 1992, 38(7):672-677
Hypercalciuria is the cause of almost 20% of all secondary osteoporoses and in 23% these cases are associated with calcium urolithiasis. It is therefore necessary to search for these patients actively because their treatment with hydrochlorothiazide and amiloride is easy and highly effective. We must not be satisfied with the finding of hypercalciuria as the only cause of demineralization of bone, as several causes may combine in a single patient. Comprehensive treatment of osteopenia associated with hypercalciuria is relatively shorter and more successful than in other forms of secondary osteopenias.
[Anti-idiotype antibodies to specific HLA. Incidence after bone marrow transplantation. Specificity and binding activity].
A Májský
Vnitr Lek 1992, 38(7):678-684
Anti-idiotype antibodies against HLA specificities anti-HLA-A1, -A2, -A9, -A10, -B7, -B8, -B12 were detected in sera of 13 patients after transplantation of bone marrow and in five patients who had no transplantation but many blood transfusions. They had a multispecific character, inhibited concurrently 4-5 of the mentioned HLA antibodies. HLA antibodies were not present in sera of these patients and did not develop even after treatment with dithiothreitol. It seems therefore that anti-idiotypic antibodies have also a IgG structure. The bond of anti-idiotype antibodies with HLA specificities was firm and maximal: they were not released after 24 hours...
[Immunotyping of medullary and circulatory cells for prognostic evaluation of plasmacytoma].
A Sakalová, D Holománová, M Mikulecký, M Mistrík, M Steruská, T Lipsic, I Chabronová, M Prümmerová, S Gazová, M Benzová
Vnitr Lek 1992, 38(7):685-692
The authors discuss the prognostic impact of immunophenotyping of circulating lymphoplasmatic cells in the peripheral blood stream in patients with generalized plasmocytoma. From a group of 250 patients followed up from 1981 to 1991 they selected a sub-group of 70 patients where they evaluated in 1986-1991 after six-month intervals the phenotype of medullary and circulating cells. They used the method of immunofluorescent detection of the presence of cytoplasmic Ig, the kappa-lambda index and phenotyping of antigens CD 9, CD 10, CD 20, CD 38, HLA-DR by monoclonal antibodies. In a longitudinal investigation of the survival period they revealed that...
[How knowledgeable are Czech physicians regarding risk factors for ischemic heart disease?].
J Widimský, P Janský
Vnitr Lek 1992, 38(7):693-695
The authors present the results of an enquiry made by means of questionnaires in which 298 physicians participated. The enquiry was focused on risk factors of ischaemic heart disease. 41.8% physicians did not know their cholesterol level, 22.1% admitted that they smoked and another 17.8% were ex-smokers. Only half the physicians indicate dietetic treatment of hypercholesterolaemia when the blood level is 6.2 mmol/l. These and other data in the paper indicate that behaviour and knowledge of physicians as regards prevention of cardiovascular diseases most be substantially improved.
[A case of systemic mastocytosis].
J Lazúr, M Takác, P Jonás, J Ponist, E Jurenková
Vnitr Lek 1992, 38(7):696-700
The authors describe a rare case of systemic mastocytosis without skin infiltration. The first symptom were episodes of flushing in the face and upper trunk. From the case-history it was assumed that the condition had a several year's benign course, the diagnosis was established in the stage of malignant acceleration of the disease from bone marrow biopsy and liver biopsy. Atypical mastocytes displayed metachromasia with toluidine blue and positive naphthol-AS-D chloroacetate esterase. Symptomatic treatment with sodium cromoglycate reduced temporarily the frequency of flushing episodes, but it was not possible to arrest the increase of the mastocyte...
[Oxalosis in patients on regular dialysis therapy].
J Tocík, P Knetl, K Khun, J Vachtenheim
Vnitr Lek 1992, 38(7):701-706
The authors draw attention to the case of a 46-year-old man who developed after three years of regular dialyzation treatment three times a week the first manifestations of acquired generalized oxalosis. The oxalosis was most marked on the skin, skeleton, heart, and kidneys. Oxalosis was confirmed after eight years of dialysis after death by post-mortem and histological examination and microscopic detection of oxalate crystals. The authors recommend that as part of regular dialyzation treatment patients should not be given more than 100 mg ascorbic acid per day. Oxalates are also the end product of degradation of ascorbic acid and high doses may lead...
[Angiodysplasia--a cause of severe hemorrhage in the gastrointestinal tract].
M Sorf, V Krislo, R Biermann, M Gogora, M Kascák, I Jablonský
Vnitr Lek 1992, 38(7):707-710
The authors describe a case of relapsing severe haemorrhage from angiodysplasias localized in the small intestine in an eighty-year-old female patient diagnosed only after probatory laparotomy. They discuss the diagnostic possibilities in angiodysplasia of the gastrointestinal tract and how it can be influenced by therapy. Even after resection of the affected portion of the intestine the formation of new angiodysplasias must be foreseen in previously intact areas and those can be the source of further severe haemorrhage.
[Psychosomatic aspects of arterial hypertension].
I Balazovjech
Vnitr Lek 1992, 38(7):711-714
In patients with labile hypertension aged 18-25 years the authors observed an increased sympathicoadrenal reactivity to mental strain caused by solution of a numerical square, parallel with a rise of diastolic blood pressure. Despite the fact that we do not know so far to what extent prolonged mental strain participates in the genesis and development of essential hypertension, the findings of the influence of some types of short-term strain on an acute rise of the blood pressure in hypertonic subjects should be used to modify the non-medicamentous procedure in treatment of the disease.
[Lipoproteinemia and diabetes mellitus].
V Růzek
Vnitr Lek 1992, 38(7):715-720
The author presents a review on lipoprotein metabolism in diabetes mellitus type I and II. He discusses the position in different lipoprotein classes--in particular LDL, VLDL, HDL and draws attention to the role of apolipoproteins and the association between lipoprotein disorders and complications of atherosclerosis in patients with diabetes of type I and II. The author deals also with the influence of genetic factors in the aetiology of hyperlipoproteinaemias.