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

The importance of noninvasive methods in cardiology has continuously been increasing; beside electrocardiography, phonocardiology, bicycle ergometry, echocardiography, radioisotopic examination and nuclear magnetic resonance, mechanocardiography preserves its significance, too. There are several reasons for it: modern apparatus technique has brought a pronounced increase in examination accuracy, comparison with invasive methods showed a number of mechanocardiographic data to be of value for left ventricular function evaluation, mechanocardiography is especially useful in repeated and long-term functional observation of the left ventricle, evaluation of treatment effects, revealing the onset of left ventricular dysfunction, the method is relatively economical and applicable even in peripheral workplaces. The literature survey of the study sums up the present knowledge of mechanocardiographic techniques, the genesis of curves and the manner of their evaluation, the physiological and other influences on the mechanocardiographic data and their clinical utilization. An analysis of experience gathered in a number of laboratories all over the world demonstrates the need of further improvement and development of the method. The present dissertation is aimed at this goal. I has set itself a task to contribute to the solution of some methodological problems of mechanocardiography and to evaluate critically its importance for the clinical practice. Polygraphy and apexcardiography (including 1st derivatives of curves) performed both at rest and during isometric handgrip exercise were used. From the obtained curves a wide spectrum of parameters was determined and several indices were calculated, some of them being introduced originally. The mechanocardiographic data were correlated in some studies with the results of echocardiography and bicycle ergometry and with invasive examination (heart catheterization, coronarography). The following results were obtained in the research into mechanocardiographic methodology problems: the suitability of a LPA 100 transducer of Czechoslovak production (Tesla VUST) was demonstrated; some physiological influences on the obtained values were determined (effects of age, respiration, body weight). The author's own method of cardiac cycle intervals correction to comparable values at unified cycle duration was elaborated; the effects of isometric handgrip exercise were studied in detail. The work was focused on verifying the importance of mechanocardiography for clinical cardiology. Therefore the method was used in a number of diseases and pathological conditions to get more complex experience. On the basis of the results obtained the value of mechanocardiography application in coronary artery disease has been demonstrated. The method provides a certain possibility in CAD diagnosis by means of combined evaluation of three sensitive parameters (pulse transmission time and two parameters of alpha wave amplitude). This type o

Contrast left ventriculography is generally used for evaluation of the left ventricular function in the patients with ischemic heart disease. This study tries to summarize contemporary knowledge on possibilities and limitation of clinical application of this method. A survey of available literary reports suggested to evaluate even diastolic filling rate and objective evaluation of wall motion.

Since April 1975 to the end of 1988 permanent cardiac stimulation was employed in 2,309 patients. The stimulating electrode was placed in the right ventricle in 2,258 patients and in the right atrium in 29 patients. Two electrodes were introduced in 22 patients one in the right ventricle and the other in the right atrium. All electrodes were introduced directly through the subclavian vein. No other approach was used. Serious complications appeared in 4 patients (i. e. in 0.17%). Pneumothorax on the side of the introduced electrode occurred in 3 patients. One woman of 80 died in connection with this complication. Another woman, who was overdosed with Pelentan, experienced hemothorax on the side of electrode insertion. After drug discontinuation and thoracic puncture the patient was doing well. In our opinion the subclavian approach for permanent electrode introduction is much more convenient than the introduction via either the cephalic or the jugular vein respectively. The former approach is considerably quicker and less traumatic in use. This method may be used in practically all patients. The repetitive introduction of the electrode through the same subclavian vein is much appreciated in patients in whom a new electrode has to be introduced. This method may be used for right atrium stimulation and for sequential pacing as well.

The representative trial has been performed in four types of East Bohemian geriatric institutions. Following totals were investigated: 193 patients of the long-term care institutions, 492 subjects residing in homes for aged, 96 in homes for pensionaries and 105 in homes with day-care. Various social and health characteristics have been scrutinized as follows: age, sex, residence, employment, reason for the admission, duration of stay, subjective complaints, vision and hear disorders, speech defects, denture status, incontinency, mobility, self-sufficiency, occurrence of chronical diseases, complexive evaluation of somatic and psychic conditions as well as the dependence on environs. Mentioned institutions are stated as varying in the majority of studied characteristics with relation to the pattern of persons admitted. The home for aged became a final institution from which the complexive care is awaited including its provision for elderly people, both patients and those self-unsufficient. The complexiveness of long-term institutional care results from the analysis of obtained data as well as its better and comprehended resolution in the future.

Propafenone hydrochloride (Rytmonorm, Prolekofen) belongs to the membranous anti-arrhythmical agents of IC group. Simultaneously, it produces a mild beta blocking effect and blocks slow Calcium channels. The mentioned agent is of current use in treating both the supraventricular and ventricular tachyarrhythmias. Literary experience is referred to in management of arrhythmias with propafenone as well as electrophysiologic properties, pharmacokinetics, hemodynamic effect and side-effects.

It outflows from a survey of 174 cases operated during five years for skull injuries that the resulting state depends of preoperative level of consciousness. In injuries with the loss of consciousness, there is a close correlation between the type of motor-topain response and the resulting state. It was stated from the delay for up to 5 years after surgery that the independence from the day life has been achieved in 65% of injured patients which experienced preoperatively a mild loss of consciousness as they localized the pain stimulus or produced unintelligible sounds in response to pain. The similar condition has been achieved in only 14% cases of preoperatively deep loss of consciousness, which responded to pain or not with decerebrative extension, or unconsciously flexion of extremities. The resulting state is less dependent of operative diagnosis. Epidural hematomas show better results, where the independence of the day life has been achieved in 62% of cases. The majority of them was able to perform their previous working activities later on. In contrast, the worst results were achieved in association with brain contusions, where only 18% of injured patients sustained the independence of environs with no return to the previous work. Prognostically, the factor of age is the most important. In the age group over than 60 years, the mortality represented 58%, whereas in 20-40 years of age it was only 24%.

The authors present their experience on Gallays' silver staining of vascular basal lamina--especially of microcirculary bed--in human and rat brain and spinal cord. They pointed out that the quality of impregnation was strongly influenced by a duration of formol fixation and pyridine senzibilization. When using sections of equal thickness they demonstrated this method offers a more complex angioarchitectonic pattern then India ink injection in vessels' lumina. More over the so called intercapillary bridges including their dynamics, origin and regression are uniquely revealed by this method.

Authors studied the oxygen demand by E. coli suspensions (serotypes 023 and 026) modifying it with various concentration of Rolitetracyclin, and proceeded by comparison of both serotypes. Time dependence of oxygen demand has been determined using the direct Warburg's manometric method. The obtained results are summerized as following four points: 1. Tested Rolitetracyclin doses caused the decrease in oxygen demand of E. coli suspensions significantly for the majority of time intervals. Rolitetracyclin actioned similarly in both serotypes. 2. Rolitetracyclin 0.5 microgram concentration actioned bacteriostatically on both serotypes, and showed more pronounced action on E. coli 026 serotypes with higher metabolic activity. 3. Rolitetracyclin 5 and 50 micrograms bactericidal concentrations inhibited markedly the oxygen demand in both serotypes. 4. Using this method allowed to determine the difference in metabolic activity of both E. coli serotypes tested.

Cytotolerance of several implantative materials has been tested on the in vitro cells. The majority of mentioned materials showed inertion without influencing cells contacting them. They were saphir, "CH" ceramic and bioactive glass-ceramic "BAS". In contrast, the sample 5 of bioglass and partly "M" ceramic sample displayed interaction with cells. On macrocontact observation of cytotolerance, the area has been stated to create around samples in which strongly degenerated and dead were rarely scattered. These substances showed interactions with cells what is confirmed by clinical observation as well.

A total of four children (1 female and 3 male subjects aged from 3.5 to 10 years) is reported as treated by surgery and antibiotics for the abdominal focus of actinomycosis. The infection was manifested as an infiltration around the inflamed appendix in one case, the second case was related with multiple infiltrations in the abdominal wall and pelvic region. Two patients showed cyst and eventually urachal sinus infiltrated with actinomycosis. The diagnosis was determined in all cases from histology. In three cases, the inflammatory tumor was exstirpated in toto. The treatment with penicillin combined with streptomycin or other antibiotic has lasted no longer than 6, 28, 29 and 80 days, respectively. The emphasis is made on the benefit of resectional surgery which reduces the amount of antibiotics needed and shortens the therapeutic course of actinomycosis.