Sbornik vedeckych praci Lekarske fakulty Karlovy univerzity v Hradci Kralove. Supplementum最新文献

The hyperlipidemia may be influenced with both the conservative and surgical management. Starting from 1987, authors use Buchwald's (1963) partial ileal bypass method. They report on their experience with 16-membered total of patients. In majority of patients, the PIB was auxiliary operation mostly in relation with vascular reconstructive surgery. No lethality case or serious complication has been stated. All patients showed the substantial decrease in cholesterol and triglyceride levels, these being normalized in majority of patients. Authors are discussing PIB indications. The suggestion is made that this is the most effective of known measures in attempt to achieve a continual decrease in lipids without the serious discomfort for a patient.

Authors describe two cases of computer operators (female subjects) which experienced face skin disorders in connection with computer's terminal staffing. The first case was concerned with acute worsening of seborrheic dermatitis, the second one with photosensitive reaction complicated partially by psychogenic erythema.

In the present paper the role of linear discriminant analysis is delimitated all along with a range of problems which could be solved using this method in appropriate conditions. The analysis is given of possibilities on how to involve the decrease in number of variables in a model, and how to predict probability of incorrect classification. As an example of application, the prediction of dog survival is calculated in radiobiological experiment on the basis of biochemical and hematological values which were obtained by the 2nd day after the irradiation as well as an error probability was determined.

The significance of individual risk-factors associated with the ischaemic heart disease is known to be estimated differently in various stages. In this account, still more screening and evaluation of mentioned factors is continuously needed in facing different social, economical, demographical and geographical conditions. The analysis has been made of such risk-factors which are generally precluded as decisive ones (age, sex, blood lipid levels, cigarette smoking, higher blood pressure, obesity, diabetes mellitus). The majority of these factors and their interrelations may be influenced. Of special author's concern were different dependencies between the selective groups of coronarographied patients and the groups defined with mainly clinical symptomatology. Authors suggest that the analysis of proper group may be supportive in order to formulate such a complicated topic and outline the appropriate trends of secondary prevention also in their conditions.

The attherosclerosis risk-factors occurrence is studied in the present paper and compared with that of abnormal coronarogram in 376 male subjects. As an abnormal coronarogram is estimated this with at least one of coronaries having more than 50% of lumen obstructed. The abnormal coronarogram occurred significantly with more frequently in male patients with hyperlipoproteinemia an in smokers (p less than 0.001). In a total of male subjects with positive coronarographic findings, the significantly higher averaged levels of total cholesterol (p less than 0.01) have been stated. Authors detected the levels of total cholesterol higher than 6.72 mmol/l and those of triglycerides higher than 1.80 mmol/l are significantly exerting the influence on the value of coronarographic score. Of particular interest is a fact that no significant relation of abnormal coronarogram to the occurrence of systemic hypertension has been detected as well as to the disorders of glycide metabolism and obesity. However, mathematically significant relation has been determined between the smoking and hyperlipoproteinemia (p less than 0.001). The cigarette smoking was stated to enhance hyperlipoproteinemia as 4 %. Smokers have been found to represent pathologically increased both triglyceride and total cholesterol levels. It is to be said that the group of smokers has values of body mass index (BMI) lower ones than the group of non-smokers. Authors also revealed the disorders of glycide metabolism were related with higher occurrence of hyperlipoproteinemia in men as 1-2%. Although no significantly frequent occurrence of glycide metabolic disorders has been proved in men with abnormal coronarogram, the more detailed analysis showed those with glycide metabolic disorders were significantly higher in coronarographic score (p less than 0.05) in contrast with the group compared, and showed significantly higher occurrence of hemodynamically important stenoses than the controls. The results of the present work are believed to enlarge the knowledge about the relations between the atherosclerotic changes, their clinical manifestations and risk-factors estimated in conditions which are completely different from those of routine epidemiological studies. The necessity of primary prevention is confirmed and possible secondary measures are indicated.

The occurrence of atherosclerosis risk-factors has been studied in comparison with the rate of abnormal coronarogram in 63 female subjects. As an abnormal coronarographic finding the obstruction of more than 50% lumen of at least one of coronaries was estimated. Female subjects with hyperlipoproteinemia (p less than 0.001) and hypertension (p less than 0.05) showed significantly more frequent abnormal coronarographic findings. Coronarographically positive women revealed significantly higher levels of total cholesterol (p less than 0.05). No relationship was detected between the pathological coronarogram and glycide metabolic disorders. Of particular interest is a fact that the disorders of glycide metabolism are conditioning the occurrence of hyperlipoproteinemia in women of our group as far as 15-16% (p less than 0.001), whereas in men only as 1-2 % (p less than 0.05). These results are supporting the opinion of those authors who point on the interaction between the disorders of glycide metabolism and hyperlipidemia estimating disorders of glycide metabolism in women to be more significant risk-factor of coronary atherosclerosis than in men. Our findings are confirming specificity of profile of atherosclerotic risk-factors in women. In accord with them, the importance of hyperlipidemia and hypertension is estimated to be the most significant risk of atherogenesis. The implementation of principles of primary and secondary prevention of ischemic heart disease is carried through the common approaches in both men and women.

The total of 376 male and 63 female subjects is concerned. As an abnormal coronarogram, such a finding is estimated where at least one of coronaries showed more than 50% lumen obstruction. The occurrence rates of atherosclerotic risk-factors, angina pectoris and myocardial infarction have been studied with regard to the abnormal coronarograms. A special concern in male group is almost simultaneous occurrence of angina pectoris along with positive coronarogram. The occurrence of both studied factors shows an increase with more age. The percentage of IM occurrence is practically the same in all age groups studied regardless to the value of coronarographic score. However, the male subjects with both clear and suspected IM (especially in the age group up to 40 years) are stated to show higher occurrence of normal coronarographic findings (32 %). This is in agreement with the suggestion that also other factors are involved than the atherosclerotic affection of coronary bed, what demonstrates the complexness of pathophysiological mechanisms of IM genesis.

In the last 30 years, colorectal carcinomas have been stated to occur markedly in all industrial countries. From colonic and rectal malignant tumors, the amounts of 4225 in 1961 and 7220 in 1984 were newly registered in GDR. Thus the number of patients with colorectal carcinomas showed the decrease for up to 70.9% starting from 1961. The biochemical Krypto-Haem-SSWR screening test has been implemented during the last few years by members of proctologic section. Colorectal carcinoma was stated in 48 asymptomatic subjects aged more than 45 years, and colonic adenoma in 83, respectively. At present, the yearly screening of occult bleeding into faeces is the unique measure contributing to early recognition of colorectal carcinomas and precancerous lesions.

During the last 30 years, 280 retrosternal esophageal replacements from stem intestinal grafts were performed at GIT Surgery Clinic AM in Wroclav. Both clinical and auxiliary investigations showed the small intestine grafts have been of the best function as to the food passage. In esophagi made from the large intestine, the following and mostly frequent changes occur: the dilatations of their lumina, the stop of food passage and inflammatory changes varying in both the degree and extent. Inflammatory changes as well as ulcers are rather difficult to detect by radiology. Through the last years, the Second Clinic of General Surgery AM in Wroclav provides endoscopy of artificial esophagi. Being sophisticated, this approach is of benefit in early determining pathologic changes in the esophageal wall, the collection of contents for biochemical tests, tissue biopsies for histology and the initiation of appropriate therapy.