Czechoslovak medicine最新文献

Tissue samples from the right atrium and ventricle of the same heart were obtained during surgery on 45 children operated on for congenital heart disease (tetralogy of Fallot, ventricular septal defect). Significant enzyme activity differences were found between atrial and ventricular muscle. Aerobic metabolism enzymes (citrate synthase, malate dehydrogenase), with lactate metabolism (lactate dehydrogenase) and fatty acid oxidation (hydroxyacyl-SoA dehydrogenase) showed significantly higher activities in ventricular muscle tissue. In contrast, hexokinase, the enzyme responsible for glucose phosphorylation was significantly higher in the atria. Hence, the right ventricle can utilize and oxidize to the full all the main nutrients (fatty acids, glucose and lactate) while the right atrium utilizes primarily glucose. These atrio-ventricular differences are independent of the type of congenital heart disease and their existence can be presumed in healthy persons, too.

Significantly more beta 2-m is released in MLCs than in control cultures of cells from one donor or in cultures of pooled irradiated cells from several donors. Beta 2-m release increases with cultivation time and depends on the intensity of stimulation. It is highest in three-way MLCs and lowest in one-way MLCs when cells of haploidentical individuals are cocultivated.

After cardiac surgery performed with extracorporeal circulation (ECC) involving heart valve prostheses (PHVS, n 12) and after a bypass of the coronary arteries by a venous graft (CABG, n 19), the authors investigated the dynamics of changes of haemostasis on the 1st, 3rd, 6th, 10th and 21st day after operation. As anti-thrombotic treatment after PHVS anticoagulants were used, after CABG thrombocyte inhibitors. On the 1st day after operation in both groups thrombocytes decline, while after the 10th day their numbers increase. From the 6th day there is in both groups a rise of fibrinogen and other proteins of the acute phase (alpha-1-antitrypsin, orosomucoid and ceruloplasmin, while there was a drop of transferrin. On the 3rd and 6th day after operation fibrinolysis activators decline (euglobulin fibrinolysis). These findings suggest an increased risk of thrombophilia during the postoperative period and are probably associated with the release of interleukin-1 after Ecc and the stress of cardiac surgery. In patients with CABG on the 1st day a major drop of thrombocytes occurs, on the 6th day an elevated fibrinogen value was recorded and on the 10th day a reduced fibrinolytic activity, as compared with patients with PHVS. These changes will be, however, associated rather with a greater development of general atherosclerosis in patients with CABG, which leads to a further alteration of haemostasis, rather than with the applied antithrombotic treatment.

The authors describe the case of a 24-year-old woman with valve disease. After a bout of respiratory tract infection, she was diagnosed to have bacterial endocarditis associated with mitral valve disease. The causative agents isolated included Eikenella corrodens, Streptococcus intermedius, Bacteroides oralis and Bacteroides bivius. At the same time, the patient was found to have developed IgA immunodeficiency. A complication accompanying the cardiac disease was spontaneous pneumothorax. Since antibiotic therapy had failed, the mitral valve was replaced by a prosthetic one. After the procedure, the patient had her teeth examined. The examination revealed complete destruction of tooth 36, thick layers of calculus and chronic gingivitis. E. corrodens was isolated also after microbiological examination of the patient's oral cavity. The reason for reporting on what we regard as an interesting case is that bacterial endocarditis with E. corrodens implicated as the causative agent is relatively rare; to date, polymicrobial endocarditis due to E. corrodens and other microorganisms has been described in intravenous drug addicts only.

In 1985-1988, 11,046 working people of the district of Bruntál, aged 45-69, were examined for occult bleeding into the stools, using the Haemoccult test. The return rate of the tests was 92.05%. Screening detected 241 patients (2.18%) with positive stools test results who were referred to further examination. 129 patients (1.17%) were found to have one or more adenomatous polyps or adenocarcinoma in the large intestine. Adenocarcinoma was detected in 15 cases (0.13%): eight in stage Dukes A, two in stage Dukes B, three in Dukes C, and two in Dukes D stages. Endoscopic polypectomy or surgical operation were used for treatment. The programme of screening for colorectal carcinoma as elaborated for the low-risk group of asymptomatic subjects over 45 years of age helps to detect less advanced stages of this oncological affection.

Phytohaemagglutinin-stimulated lymphocytes from 20 young (16-28 years) and 20 old (70-88 years) healthy subjects were examined for chromosome aberrations before and after exposure to bleomycin in the G2 phase of the cell cycle. No differences were found in unexposed cultures between young and old donors. After treatment with bleomycin, the rate of chromosome aberrations was significantly higher in the elderly persons (p less than 0.05). As the results suggest, different interaction between the mutagen and DNA may be caused by the decreased capacity of the excision repair system in the elderly individuals cells.

The authors pay increased attention to issues concerning correct interpretation of mechanical phenomena of the hard tissues that facilitate interdisciplinary cooperation with technical specialists. Equal attention is paid also to terms of compressive stress and compressive strain. Analyzing the crown of the teeth the authors found striking coincidence between the developing dental caries localization and lower values of compressive strains. The relationship found between dental caries and mechanical strains offers stimuli for new preventive measures. The present study furthermore points to the importance of medical bionics and its methods for solving some other problems of the gnathic system.

A total of 170 patients with chronic myeloid leukemia (CML), 107 in chronic phase (CP) and 63 in blastic phase (BP) of the disease, 187 patients with "de novo" acute myelogenous leukemia (AML) and 175 patients with myelodysplastic syndrome (MDS), 164 patients with primary and 11 with secondary MDS, were cytogenetically examined. All patients with CML were Ph positive, additional chromosomal changes were ascertained in 29% of patients in CP and in 71% of patients in BP. The most frequent chromosomal abnormalities were trisomy 8, additional Ph, (i(17q] and loss of Y chromosome. More favorable course of the disease was observed for group of patients with Ph chromosome as solitary chromosomal abnormality in CP. Acquired chromosomal aberrations were proved in 137 patients with AML (73.3%). Except specific chromosomal changes delineated according to the specific subtype of AML we were concerned with evaluation of nonrandom chromosomal abnormalities, specially those involving chromosome 5 and 7. Numerical and morphological changes of those chromosomes were found in 33 patients (17.6%). In MDS patients abnormal chromosomal clones were found in 68.8% of patients, those involving chromosome 5 and/or 7 in 68 patients (38.8% of all examined). The frequency of these abnormalities in AML does not differ significantly from the results quoted by the other studies. However, in our MDS patients these so called "mutagen-associated" chromosome abnormalities were significantly more frequent than in all studies published so far. Prognostic value of cytogenetic examination was evaluated on the basis of cumulative survival of patients with normal and abnormal chromosomal clones present in bone marrow cells.

84 patients in the second or third stages of serologically diagnosed Lyme disease suffering from different forms of central as well as peripheral nervous system involvement were tested for the participation of autoimmune mechanisms. Cell hypersensitivity to the encephalitogenic basic protein and to antigens from peripheral myelin was evaluated on an Opton cytopherometer according to the effect of the macrophage slowing factor--liberated during short-term incubation of sensibilized lymphocytes by the respective antigen--on the mobility of tannin-treated sheep red blood cells in an electric field. Judged by the presence of autoimmune reactions. Lyme disease has come to occupy a prominent position compared with previously examined other types of neuroinfections. An explanation can be sought in disordered immunoregulating mechanisms, even though the changes in total and active T lymphocytes were not statistically significant. Data on immunological changes are relevant for the indication of immunomodulating therapy as a suitable complement to antibiotic treatment.

The authors assessed the levels of lactate and 2,3 diphosphoglycerate in the umbilical blood of 105 full-term neonates. A significant increase was found in the levels of 2,3 diphosphoglycerate in newborns of mothers with a history of imminent chronic intrauterine hypoxia. The lactate levels of these newborns were the same as in children of mothers without a history showing a risk of intrauterine hypoxia. The psychomotor development of newborns with increased levels of 2,3 diphosphoglycerate was significantly more altered than in those with normal levels in their first year of life.