Vnitřní lékařství, 1998 (roč. 44), číslo 2
[Celiprolol improves glucose metabolism in essential hypertension].
A Oksa, V Fedelesová, V Spustová, R Dzúrik
Vnitr Lek 1998, 44(2):63-67
The authors investigated in 18 patients with essential hypertension the action of celiprolol (usually in combination with a diuretic) on the glucose and lipid metabolism in an open three-month trial. They evaluated the glucose, insulin and C-peptide concentration during an oral glucose tolerance test (oGTT) and the serum lipid concentration before and after treatment. It was revealed: 1. There are no significant changes in the glucose, insulin and C-peptide concentrations on fasting, 2. There is a significant reduction of the blood sugar level during the second hour of oGTT after treatment, 3. A significant reduction of glucose and C-peptide during...
[Relation between levels of leptin, insulin and cortisol in persons with the 5H (X) syndrome].
J Hrnciar, J Okapcová, J Lepej, D Gábor
Vnitr Lek 1998, 44(2):68-75
Leptin levels in subjects with android obesity with the insulin resistance syndrome (syndrome X, 5H) are in general elevated, as compared with non-obese subjects and correlate with the BMI, with the percentage of body fat, WHR, IRI levels and sex (they are higher in women), as it is the case in the general population. In the elevated leptin level in syndrome 5H (association of hyperinsulinism, hyperglycaemia-NIDDM, hyperlipoproteinaemia with android obesity, arterial hypertension and hirsutism in females with the polycystic ovaries syndrome) participate in a significant way also elevated basal IRI and cortisol levels as well as an elevated postprandial...
[Frequent incidence of thyropathies in women with breast carcinoma].
Z Límanová, J Barkmanová, Z Friedmanová
Vnitr Lek 1998, 44(2):76-82
In a group of 82 women with breast cancer selected at random 10 had treatment on account of thyroid disease. In 43 women the authors found a positive titre of antibodies against thyroid antigens, indicating autoimmune affection of thyroid tissue. Although none of the patients reported thyroid complaints a total of 11 women of the group (13.4%) had TSH values in the pathological range. Based on slightly elevated TSH levels and/or a positive TRH test the authors diagnosed 11 new cases of subclinical hypothyroidism and in two women subclinical thyrotoxicosis. They did not prove a relationship between thyroid disorder and chemotherapy or hormonal treatment....
[Indicators of effects of free radicals in workers at risk of lead exposure].
V Machartová, J Racek, J Kohout, V Holecek, I Krejcová, V Senft
Vnitr Lek 1998, 44(2):83-85
The authors examined indicators of the action of free radicals in 40 workers exposed to the risk of lead (work with lead containing glazing and prints). The lead concentration in the atmosphere did not exceed the highest permissible concentrations and the biological exposure tests as regards lead exposure did not exceed the highest permissible limits. In the examined subjects the authors found a significantly elevated level of superoxide dismutase activity (p < 0.05) which suggests long-term increased peroxide formation. The correlation of the selenium concentration in blood and the period of lead exposure was at the borderline of statistical significance...
[Steroid osteoporosis].
J Kocián
Vnitr Lek 1998, 44(2):86-92
The author demonstrates on a group of 292 patients (207 women, 85 men) treated on account of various diseases with corticoids laboratory parameters and bone density and records of bone fractures. The bone metabolism is negatively influenced by the action of corticoids on the vitamin D transformation into its active metabolites; as a result of reduced calcium absorption from the gut the reduced calcium level in blood causes secondary hyperparathyroidism and osteoclastic bone resorption is enhanced. On the other hand, corticoids inhibit new formation of bone by suppressing the proliferation of osteoblasts and by interfering with osteoid formation. One...
[The reflex sympathetic dystrophy syndrome of the lower extremities in patients after kidney transplantation--another complication of cyclosporin A therapy?].
B Grandtnerová, J Lepej, I Marková, D Spisiaková
Vnitr Lek 1998, 44(2):93-97
The authors describe a new complication observed in patients after transplantation of the kidneys, characterized by intensive periarticular pain of the joints of the lower extremities, mostly with a symmetrical affection of the heels and knees, associated with vasomotor changes in the affected area, X-ray evidence of patchy osteoporosis and an increased periarticular activity of radionuclide on bone scans. The symptoms develop shortly after transplantation and recede within several months. The clinical findings, X-ray and scintigraphic changes are typical for the syndrome of reflex sympathetic dystrophy. The etiology of the syndrome remains obscure,...
[Hyperlipidemia after kidney transplantation and its control by individualized therapy: evaluation of the first years' trial].
V Teplan, R Poledne, O Schück, I Matl, M Stollová, O Mengerová, S Vítko
Vnitr Lek 1998, 44(2):98-103
Secondary hyperlipidaemia (HLP) is one of the most serious metabolic complications in patients after transplantations of the kidney. In its development a number of factors may participate, the most important ones being immunosuppressive drugs (cyclosporin A and prednisone) and the patients dietary habits. In a prospective metabolic trial a group of 248 patients after transplantation of the kidney with a long-term stable function of the graft were followed up for 12 months. Group I (128 patients) was systematically followed up in the Institute of Clinical and Experimental Medicine and the patients were treated by individualized dietetic and pharmacological...
[The syndrome of inappropriate secretion of antidiuretic hormone in hypophyseal tumors].
P Pontuch, V Vestenická, T Sedlák, V Porubec, S Kinová, D Jezová
Vnitr Lek 1998, 44(2):104-107
70-year old man was admitted to the hospital due to the sudden change in his behaviour with the production of unusual echolalic word connections. Arginin-vasopressin (AVP) level (1.16 pg/ml) was found inappropriately higher in relation to the severe serum hypoosmolality (261 mmol/kg) and hyponatraemia (117 mmol/l) with relatively high urinary osmolality (590 mmol/kg) and natriuria (684 mmol/24 h). Diagnosis of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH-type C) was confirmed during the water load test. Magnetic resonance imaging and CT scans revealed in the region of hypophysis intrasellar tumour (diameter of 16 mm) and the...
[Progressive multifocal leukoencephalopathy in a female patient after kidney transplantation].
P Táborský, J Hrabánek, A Jirásek, I Matl
Vnitr Lek 1998, 44(2):108-110
The authors describe the case of a 66-year-old female patient after transplantation of the kidney where a rare complication of immunosuppressive treatment was diagnosed--progressive multifocal leukoencephalopathy. The disease was manifested by gradually developing hemiparesis of the lower extremity five months after transplantation. Examination of the brain by computed tomography and examination of cerebrospinal fluid were normal. Subsequently the neurological finding developed into quadruparesis. Imaging of the brain by magnetic resonance revealed multiple demyelinization foci. In brain biopsy there were typical structures of progressive multifocal...
[Plasminogen activator inhibitor (PAI-1) and diabetes mellitus. II. PAI-1 in insulin resistant conditions].
P Galajda, L Sutarík, L Vladár, J Stasko, P Kubisz, M Mokán
Vnitr Lek 1998, 44(2):111-114
Insulin resistance (IR) is associated with an elevated PAI-1 level and by correlation with insulin and triacylglycerol (TG) levels. While in IR non-diabetics this relationship is close, in patients with NIDDM the mutual relationship is less marked and there are other factors which raise the PAI-1 levels such as proinsulin, oxidation stress or cytokines. Therefore achievement of satisfactory metabolic control, reduction of insulin and TG levels need not be associated with normalization of PAI-1. As it is an independent risk factor of atherosclerosis, further examinations are necessary in order to differentiate in more detail the possible causes of its...