Czechoslovak medicine最新文献

Replacement therapy of hypogonadal men with testosterone isobutyrate, 100 mg by the i.m. route every two weeks, does not lead to a permanent significant change of the lipoprotein spectrum and to an increased risk of stereogenesis. The expected changes in the liver lipase activity and in the lipoprotein spectrum under the influence of the administered androgens are obviously suppressed by the antagonistic action of estrogens formed by conversion from androgens.

The incidence of congenital heart defects was studied prospectively in all 664 218 children born in 1977 to 1984. Those suspected of having a heart disease were examined at the centre specialized in pediatric cardiology. All children who died were autopsied and those where a heart defect was proved were included in our series. In total, 4409 infants (6,64/1000 live births) were born with a heart defect in Bohemia. Differences from one year to another were not statistically significant. The incidence of infants with a heart defect was highest in October, lowest in December, June and July (p less than 0.05). Seasonal incidence of individual forms of heart defects differed also. The seasonal variation was not influenced by the total number of live births. The high incidence of congenital heart defects in infants born in October and November coincides with the epidemics of influenza in early pregnancy.

The author submits an analysis of a group of casualties with clavicular fractures treated in the Traumatological Research Institute in Brno in 1986. Based on the analysis, recommendations were adopted for the surgical treatment and for increased attention to the termination of conservative treatment. As a control, a group of patients with clavicular fractures treated in 1989 was analyzed. The assembled results are discussed and the conclusion is reached that predominantly conservative treatment of clavicular fractures is still indicated. No other method of immobilization gives better results than mere suspension of the extremity. In a certain percentage of injured patients subjective complaints typical for the healing of the fracture persist. The period of work incapacity must be assessed individually.

Similarly as in all war-ravaged countries of Europe, in Czechoslovakia, too, cardiosurgery did not begin being systematically developed until after 1945. Patent ductus arteriosus was first treated surgically in this country in 1947, the year 1951 saw the launching of surgical therapy for mitral stenosis (commissurotomy on the closed heart), 1955 - the introduction into clinical practice of open-heart surgery for simple heart defects (DSS, pulmonary artery stenosis and aortic stenosis) with the patient in 28 degrees C hypothermia and with the blood circulation arrested for brief periods of time. In the years 1958-1959, four Czechoslovak cardiosurgical centres began to provide surgical treatment for congenital and acquired heart defects in extracorporeal circulation. Considering the war-inflicted material and personnel shortcomings prevailing in those times, Czechoslovak cardiosurgery managed relatively soon to attain the standard of cardiosurgery of the western countries, thus testifying to the viability of the country's post-war health care services. At present, there are six cardiosurgical centres in this country systematically engaged in the surgical treatment of congenital and acquired heart defects and providing the diagnosis and surgical correction of heart defects on a professional scale equal to that in countries with advanced health care systems. While the care provided at Czechoslovak cardiosurgical centres is comparable in terms of quality, the productivity of those centres leaves much to be desired. Ways and means of coping early with this inadequacy are looked for with the help of the Ministry of Health.

This work deals with preclinical stages of diabetes mellitus in 494 first-degree relatives of insulin-dependent and non-insulin-dependent diabetics: 182 parents and 66 siblings of diabetic children, 176 offspring of diabetic mothers and in 70 offspring of both non-insulin-dependent diabetic parents. In these persons the family history, oral glucose tolerance test and insulin secretion were studied, blood levels of lipids and fibrinogen were investigated, neurological examination was performed, the neurocirculatory deviations and changes on the fundus were observed and HLA antigens were typed in comparison with the control groups. Long-term follow-up proved, that offspring of both non-insulin-dependent diabetic parents are the most homogenous group. Fluctuating development of abnormalities of glucose tolerance during a long period from a relative early age of 30-40 years with primary insulin resistance, compensatory hyperinsulinism and its delayed secretion and later with relative insulin deficiency are characteristic. Such development is associated with an increase body weight and of blood pressure and often with elevated lipid and fibrinogen levels.

Administration of putrescine, a polyamine, to rats leads to endothelial injury manifesting itself by an increased number of endothelial cells circulating in blood. Moreover, putrescine affects the metabolism of the arterial wall itself, primarily by increasing the activity of phosphomonoesterases I and II and by decreasing the activities of Krebs cycle enzymes, both of which are phenomena that can be regarded as "preatherogenic" changes 5, 6, 8, 11 preceding the onset of pathological processes in the arterial wall. Putrescine significantly decreases aortic ATPase (adenylpyrophosphatase) both in the acute and chronic phases of experiment. Ultrastructural changes after 16 weeks of putrescine administration manifested themselves in increased proliferation and smooth muscle cell injury eosinophil inflitration into the adventitia. The findings support the hypothesis that high levels of PA in homocysteinemic patients and those on chronic dialysis are a common denominator accelerating atherosgenesis in these subjects.

The authors compared the results of two radioimmunological methods for the estimation of immunoreactive calcitonin in human serum. Parallel with the commercial RIA kit the estimation was made by the authors' own modification of this process with their own specific antiserum and radioligand prepared in the laboratory. The results in a large group of patients with medullary carcinoma of the thyroid gland (MCT) in different stages of the disease revealed that although the values obtained by the two methods differ, there is a statistically significant correlation between the values and the clinical evaluation is also comparable.