[Regulation of HDL lipoprotein plasma levels in relation to atherogenesis]. / Regulace plazmatických hladin HDL lipoproteinu ve vztahu k aterogenezi.

There is no doubt nowadays on the importance of HDL lipoproteins in atherogenesis. In the submitted review the author presents information on the regulation of HDL lipoprotein plasma levels and their sub-classes. First he deals with metabolic relations, in particular synthesis and catabolism of HDL lipoproteins. He mentions then factors which influence plasma levels of HDL lipoproteins and their sub-classes--external and internal factors. As to internal factors the author discusses genetic predisposition, sex, age, obesity, adipose tissue distribution; as to external factors the effect of diet, exercise, alcohol, smoking and drugs.

[Dissecting aortic aneurysm combined with hepatorenal syndrome]. / Disekující výdut' aorty kombinovaná hepatorenálním syndromem.

The authors present a case of a dissecting aneurysm of the aorta type A which affected also the insertions of visceral and renal arteries, and in addition to renal ischaemia and impaired renal function caused also ischaemia of the liver parenchyma with a rise of transaminases and bilirubin. This led to temporary hospitalization at the infectious department where the patient was referred to rule out hepatitis. In the discussion the authors draw attention to the pathogenesis, differential diagnosis and contemporary therapeutic methods of the disease.

[Extrapulmonary tuberculosis with involvement of the reticuloendothelial system and secondary lupus vulgaris]. / Mimoplicní tuberkulóza s postizením retikuloendotelového systému a druhotným lupus vulgaris.

The authors describe a case of extrapulmonary tuberculosis with affection of the reticuloendothelial system in a 59-year-old female patient. After successful treatment the findings in the spleen, bone marrow and the laboratory results had normal levels. The authors draw attention to the diagnostic difficulties. They were able to confirm the diagnosis only by histological examination of biopsy from the pelvic bone. An interesting finding was eruption of lupus vulgaris on the legs in the course of treatment. The authors discuss some aspects of the disease and its differential diagnosis.

[Mechanical lithotripsy of a gastric bezoar]. / Mechanická litotripse bezoáru zaludku.

At the First Medical Clinic of the Faculty Hospital Prague Motol the authors detected during a routine gastroscopic examination of a 71-year-old female patient the presence of a gastric bezoar. The examination was indicated on account of dyspeptic complaints. With regard to the size of the bezoar (50 x 20 mm) the authors decided for mechanical lithotripsy. It proved possible to reduce the concrement during the first session and during subsequent sessions it was broken down to small size and the fragments were eliminated per vias naturales. Several fragments were extracted. Chemical analysis provided evidence of the origin of the concrement in the biliary pathways--the concrement was pure cholesterol. ERCP did not reveal an artificial communication between the biliary system and the stomach or duodenum. It did not prove possible to visualize the gallbladder by ultrasonography. The selected therapeutic procedure was successful.

[Ultrasonography of the kidneys for the detection of incipient diabetic nephropathy]. / Praktický prínos ultrasonografického vysetrení ledvin pro stanovení zacínající diabetické nefropatie.

At the First Medical Clinic of the Faculty Hospital in Prague 5 Motol a group of 15 men and 14 women treated on account of type I diabetes for a mean period of 12.8 +/- 5.8 years was examined. Their mean age was 26.3 +/- 5.8 years and their BMI 23.91 +/- 2.82. The control group was formed by 18 healthy subjects (10 men and 8 women) mean age 23.8 +/- 8.9 years, BMI 22.44 +/- 2.48. All subjects were subjected to a detailed ultrasonographic examination and, assessment of microalbuminuria. From the assembled sonomorphometric data the volume of the right kidney was related to the BMI and thus the renal volume index (RVI) was obtained. In the group of diabetic subjects a statistically significant correlation was found between RVI and microalbuminuria (r = 0.574, p < 0.01). In the group of patients with RVI higher than 7.44 a close correlation was found between microalbuminuria and RVI (r = 0.993, p < 0.05). In the group of patients with a duration of diabetes under 5 years no correlation between the investigated parameters and the RVI was found, nor a mutual correlation of parameters. In patients with diabetes persisting for 5-20 years correlation was found between microalbuminuria and RVI (r = 0.686, p < 0.01). In the group of patients with diabetes for more than 20 years there was no correlation between RVI and other indicators.

[Lipostat in the treatment of hyperlipoproteinemia]. / Lipostat v lécbe hyperlipoproteinémií.

Within the framework of clinical tests of LIPOSTAT (pravastatin tablets 20 mg Bristol Meyers-Squibb Co.) this hypolipidaemic preparation was administered to 28 patients with different types of hyperlipoproteinaemias, mainly of type IIa. Administration for a period of four weeks--20 mg in the evening--had a significant effect on several basic indicators of the lipid metabolism. The total plasma cholesterol level declined by 20%, the apolipoprotein B level by 11%, the HDL cholesterol level rose by 38% and the triacylglycerol level declined by 18%. During administration the serum levels of aminotransferases, creatine kinase and alkaline phosphatase did not increase. No adverse side-effects were observed which called for discontinuation of treatment. Pravastatin is according to the authors' experience and the results of others an effective hypolipidaemic agent, suitable for the majority of patients with hyperlipoproteinaemias, in particular those with elevated plasma cholesterol levels.

[Cystic lymphangioma of the retroperitoneum]. / Cystický lymfangiom retroperitonea.

The authors present the case-history of a patient with a cystic retroperitoneal lymphangioma. Its diagnosis was established only by histological examination of the resected tissue. The authors draw attention to the symptomatology, diagnosis, therapy and discuss contemporary views regarding the cause of this disease.

[Thrombosis of the inferior vena cava--an unusual cause of a chronic septic condition in a female patient with type 1 diabetes mellitus]. / Trombus dolní duté zíly--neobvyklá prícina chronického septického stavu u nemocné s diabetes mellitus 1. typu.

The authors describe the accidental detection of a clinically not very marked thrombosis of the vena cava inferior in a 29-year-old female diabetic which was the cause of permanent bacteriaemia and the source of embolization of the lungs. The patient was delivered of an infant six years previously by Caesarean section, subsequently complicated by a paranephritic abscess on the right which called for surgical treatment. Since then the patient suffered from frequent dermal infections and was dyspnoic. Because of deterioration of polyneuropathic complaints of the lower extremities resulting from diabetes the patient was admitted to the authors' clinic. Sonographic examination of the abdominal cavity aroused urgent suspicion of a thrombus in the vena cava inferior, as confirmed by subsequent cavography and computed tomography. The patient was treated for prolonged periods with anticoagulants and antibiotics. During the subsequent check-up examination after four months marked diminution of the thrombus was recorded and improvement of the patient's general condition.

[What are the characteristic signs of cholecystolithiasis in patients with type 2 diabetes?]. / Jaké jsou charakteristické znaky cholecystolitiázy u nemocných s cukrovkou 2. typu?

In a group of 166 patients with type 2 diabetes mellitus, hospitalized at the First Medical Clinic, Faculty Hospital Prague 5-Motol, cholecystolithiasis was found in 91. In these patients sonographic parameters were analyzed. All were hospitalized primarily on account of a non-biliary indications. The group comprised 67 men, mean age 69 years. The control group was formed by 67 patients with a normal glucose tolerance. An enlarged gallbladder was found in 15 patients (16.4%), a gallbladder of reduced size in 8 (8.8%). Stones smaller than 1 cm were in the group of diabetics in 31 subjects (34.3%), stones larger than 1 cm in 60 (65.7%). A wall of the gallbladder wider than 3.5 mm was found in 14 (15.4%) diabetics with cholecystolithiasis. All these results were statistically significant as compared with the control group (p < 0.01). There was no significant difference in the number of stones in diabetics and controls. The authors discuss the causes of these findings. In the conclusion the authors state that it is necessary to seek actively cholecystolithiasis in type 2 diabetics and indicate cholecystectomy in time to prevent numerous, in particular inflammatory, complications. For detection ultrasonography is suited best.

[Emergency states in internal medicine--diagnostic contribution of emergency abdominal ultrasonography]. / Náhlé stavy ve vnitrním lékarství--diagnostická pomoc urgentní abdominální ultrasonografie.

The authors analyzed the activities of the sonographic laboratory during four consecutive months. During this period 896 patients were examined by ultrasonography and 119 of them (13.3%) for urgently indicated ultrasonography. The authors present a detailed evaluation of results in these 119 examined patients, in particular from the aspect of yield and asset of the method, affection of different organs, agreement of clinical and sonographic diagnoses and comparison with some other examination methods. Urgent ultrasonography is recommended as a very useful method, in particular as regards diagnostic yield which makes it possible to establish the diagnosis quickly and thus to start appropriate treatment early and to reduce thus the period spent by the patient in hospital. The method is useful also in serious cases and in some conditions which threaten the patient's life, as it can help early indication of surgery.

[Lipoproteinemia and diabetes mellitus]. / Lipoproteinémia a diabetes mellitus.

The author presents a review on lipoprotein metabolism in diabetes mellitus type I and II. He discusses the position in different lipoprotein classes--in particular LDL, VLDL, HDL and draws attention to the role of apolipoproteins and the association between lipoprotein disorders and complications of atherosclerosis in patients with diabetes of type I and II. The author deals also with the influence of genetic factors in the aetiology of hyperlipoproteinaemias.

[Present views on the diagnosis of cavernous hemangioma of the liver using ultrasound]. / Soucasný pohled na diagnostiku kavernózních hemangiómu jater pomocí ultrazvuku.

The submitted review deals with morphometry, normal sonographic anatomy and the position of ultrasonography in the diagnosis of cavernous haemangiomas of the liver. The authors draw attention to the contemporary equipment used and analyze the position of other diagnostic methods in the diagnosis of cavernous haemangiomas of the liver. They discuss also the problem of percutaneous biopsy of the liver when this benign tumour is suspected. Finally the authors recommend the best procedure in the diagnosis of cavernous haemangiomas of the liver.

[Cholecystolithiasis in type II diabetics]. / Cholecystolitiáza u diabetiku II. typu.

In a group of 166 type II diabetics hospitalized in a medical department the authors made clinical and ultrasonographic examinations focused on the presence of cholecystolithiasis. The control group was formed by 67 subjects with normal glucose tolerance. None of the patients were hospitalized on account of biliary disease. The purpose of the work was to 1. evaluate the difference in the incidence of cholecystolithiasis in diabetic patients and controls with regard to age and sex, 2. to assess differences in the incidence of obesity, impaired lipid metabolism and a positive biliary family--history in diabetics and controls with lithiasis, 3. to evaluate diabetes and the presence of microalbuminuria. In the authors' group cholecystolithiasis is significantly more frequent in diabetics as compared with controls, in men, women and people above 65 years (p less than 0.01). The group of diabetics and controls with lithiasis does not differ as to the incidence of obesity, hyperlipoproteinaemia and positive family-history of biliary disease. No significant differences in parameters of compensation of diabetes nor differences in the incidence of microalbuminuria were found between diabetics with and without lithiasis. The results suggest that it is useful to screen cholecystolithiasis in diabetic subjects.