Biomedical subjects

B Král

Publications and source records attributed to B Král.

At least 19 recordsLinked to original sources

PubMed1996

S-100 protein positive (sustentacular) cells in pulmonary carcinoid tumorlets: a quantitative study of 24 cases.

Stellate-shaped S-100 protein positive sustentacular cells (SCs) appear to correlate inversely with the degree of tumor malignancy in some neuroendocrine tumors. Therefore, the SCs have been investigated in carcinoid pulmonary tumorlets and subsequently examined quantitatively in order to provide a basis for estimation of this phenomenon in tumorlet related lesions, especially carcinoids and neuroendocrine carcinomas. Pulmonary tissue from twenty-four patients with carcinoid tumorlets was studied immunohistochemically for S-100 protein positive SCs together with glial fibrillary acidic protein, actin, desmin, vimentin and cytokeratins. Tumorlet SCs were calculated per 10,000 tumorlet elements. The presence of SCs was proven in 18 subjects (75%) of all examined cases with quantitative frequency between 13 and 196 SCs per 10,000 tumorlet elements. The histogram showed three separate clusters of cases. Cluster 2 and cluster 3 with strikingly high frequency of SCs, i.e. from 66 up to 196 SCs per 10,000 tumorlet cells, may represent the biphasic differentiation potential of tumorlet elements. The mentioned lesions could be regarded as the possible precursors of pulmonary paragangliomas or paraganglioid carcinoids.

Aged↗

PubMed1996

[Satellite cells in pulmonary carcinoid tumorlets and carcinoids].

Pulmonary tissue of twenty-four patients with carcinoid tumorlets and twenty-three typical carcinoid tumors was studied immunohistochemically for stellate-shaped S-100 protein positive (sustentacular) cells. Sustentacular cells (SCs) have been calculated per 10,000 tumorlet or carcinoid elements. The presence of SCs was proved in 18 subjects (75%) of all examined tumorlet cases with quantitative frequency between 13 and 196 SCs per 10,000 tumorlet cells. These elements were also found in 18 carcinoid tumors (79%) of all 23 investigated cases with quantitative frequency between 5 and 927 SCs per 10,000 carcinoid cells. The cluster analysis showed two separate clusters in both groups of lesions with strikingly high frequency of SCs, i.e., from 66 up to 196 SCs/10,000 tumorlet elements and from 138 up to 923 CSs/10.000 carcinoid cells, respectively. SCs may not be used as an indicator of biological behaviour of pulmonary neuroendocrine tumors for their a broad frequency spectrum in examined benign lesions, i.e. tumorlets and typical carcinoid tumors.

Adolescent↗

PubMed1995

[Basal energy expenditure in smokers and non-smokers with Crohn's disease].

BACKGROUND: Crohn's disease (CD) is associated with smoking and ulcerative colitis with non-smokers. The aim of study was to compare resting energy status of smokers is worse when compared with non-smokers. The aim of the study was to compare resting energy expenditure (REE) in smokers and non-smokers with CD. METHODS AND RESULTS: REE was measured in the morning in 18 fasting patients with CD (11 non-smokers, 7 smokers) using a metabolic cart (Deltatrac Datex) in a canopy system. In smokers REE was measured before and 30 minutes after having smoked one cigarette, in non-smokers before and 30 minutes after light physical activity. The results were expressed in per cent of the expected values calculated from Harris-Benedict formula (%HB). In CD REE was significantly higher in smokers when compared with non-smokers (mean +/- S.E.M.: 113.3 +/- 12.7 vs 103.1 +/- 10.2; p < 0.03; t-test). The increase of the second measurement was not significant both in smokers (115.4 +/- 9.4) and non-smokers (105.4 +/- 10.3). In 15 CD patients substrate utilization was also estimated from indirect calorimetry and urea production. There was a higher rate of glycides (mean +/- S.E.M.: 185.9 +/- 81.9 gm/min) and a lower rate of protein oxidation (22.7 +/- 15.5) in smokers when compared with non-smokers (glycides: 141.6 +/- 78.0, NS; proteins: 41.8 +/- 36.7, NS). There was no significant difference between smokers and non-smokers with CD in lipids oxidation (33.7 +/- 19.5 vs 32.9 +/- 22.3). CONCLUSIONS: A significantly higher REE was found in smokers with CD when compared with non-smokers with CD. Differences in substrate utilization were not significant. Our results support a recommendation for CD patients to be non-smokers.

Adult↗

PubMed1995

[Malnutrition in chronic obstructive bronchopulmonary diseases].

Malnutrition occurs in 23-70% of patients with chronic obstructive pulmonary disease and appears to be an independent factor connected with poor prognosis. Malnutrition stems from a long-term negative balance of energy and nutrients. That is caused by hypermetabolism, with possible role of an increased thermic effect of food, and probably by (at least intermittently) a limited intake of food. The adverse effect of malnutrition may be mediated by a decreased respiratory muscle strength but also by other mechanisms (electrolyte disorders, disturbed respiratory control, immunosuppression). In these patients, realimentation may be difficult to achieve, especially on the out-patient basis. However, with an increased effort of the health professionals and a good compliance of the patients, a substantial improvement is feasible, which might in turn improve the patients' prognosis.

Enteral Nutrition↗

PubMed1995

[Indirect calorimetry and pulmonary function in chronic pulmonary disease].

Data derived from indirect calorimetry in patients with stable chronic pneumopathies were evaluated together with their pulmonary function data (spirometry, diffusing capacity, blood gases). Their basal metabolic rate was significantly higher (116.1% of the predicted value), this increase being more expressed in the patients with hypoxemia and with more severe obstructive disorder. In chronic obstructive pulmonary disease, the increased energy expenditure in hypoxemia was accompanied with increased lipid oxidation. There also was a correlation between the patients' nutritional status (evaluated by their body mass index) and their pulmonary function. These results confirm the impairment of pulmonary function in malnourished patients.

Basal Metabolism↗

PubMed1995

[Perception of dyspnea in asthmatics--long-term study].

The authors investigated the relationship between perception of dyspnoea and some respiratory parameters (vital capacity - FVC, one-second vital capacity - FEV 1) in 43 patients with bronchial asthma. They followed up the changes of this relationship during repeated examinations within 3 - 60 months following the first examination. They were also interested to find out whether the patients perceive a reduction of the bronchial obstruction after Berotec. The authors provided evidence that: 1. a small proportion of the patients (18.4%) do not report subjective dyspnoea even in case of major obstruction of the respiratory pathways. 2. Another part of asthmatic patients (23.2%) have an increased perception of dyspnoea, i. e. they report a certain degree of dyspnoea when FEV 1 is higher than 85% of the appropriate value. 3. Acute reduction of bronchial obstruction is inadequately perceived by 39.5% of the patients. 4. During repeated assessment the perception of dyspnoea frequently changed markedly in the same patients. These findings justify the conclusion that treatment of asthmatic patients should depend not only on the score of the patient's symptoms but also on objective monitoring of the degree of obstruction in the home environment.

Adolescent↗

PubMed1995

Breathlessness perception in asthmatic patients--clinical implications.

Dyspnoea perception in patients with asthma bronchiale varies considerably in the course of their disease intra- and interindividually. The variability tends to be age dependent, elderly patients being less aware of even severe obstruction. Blunted perception of progressive airway narrowing has been identified, as an independent risk factor of severe asthma attacks or even asthma induced death. Such patients should be provided with a peak flow meter for home objective monitoring of airway obstruction. Simultaneously, a written action plan of how to manage an impending asthma attack should be available. A small number of asthmatics has been shown demonstrate excessive dyspnoea perception when no or minor airway obstruction could be established objectively. These patients could also profit from offering them a home peak flow meter due to the calming of their distress when no airway obstruction was measured and avoiding them of drug overuse.

Asthma↗

PubMed1994

[Thrombocytes as an indicator of activity in Crohn's disease treated with total parenteral and/or enteral nutrition].

UNLABELLED: Inflammatory bowel disease can be associated with increased platelet count. Aim of our study was focused on assessing thrombocyte count in evaluation of the activity in Crohn's disease (CD). The study included a total of 19 patients [6 men, 13 women (aged 18-57 years, mean 33, median 28]. All patients were malnourished in active stage of the disease on total parenteral and/or enteral nutrition (TP/EN). Thrombocytes were estimated at the beginning and after 3 weeks of TP/EN in venous blood sample using automatic analyser Coulter Counter JT3 (normal range: 130-380.10(9)/l). Serum prealbumin, transferrin, haptoglobin, alpha 1-orosomucoid and C-reactive protein were measured simultaneously. Thrombocytes count below 400.10(9)/l was found only in 1/19 at the beginning and in 7/19 patients in the end of the study. After 3 weeks of TP/EN a significant platelet count fall was found (mean +/- sd: 472 +/- 98 vs. 354 +/- 110, p < 0.01). A correlation was found between thrombocytes and serum prealbumin (r = -0.3871, p < 0.05), haptoglobin (r = 0.5247, p < 0.001), alpha 1-orosomucoid (r = 0.4857, p < 0.01) a C-reactive protein (r = 0.4354, p < 0.01). CONCLUSION: Thrombocyte count helped in the assessing of disease activity in CD on 3-week-TP/EN. Improvement of clinical status, increase of nutritional parameters and decrease of positive acute phase reactants were associated with a fall of platelet count in 15/19 patients.

Adolescent↗

PubMed1993

Immunoglobulin G subclasses in Crohn's disease with and without bowel resection.

Increased immunoglobulin G2 [IgG2] in Crohn's disease in contrast with increased IgG1 in ulcerative colitis was reported in literature data. The aim of our study has been focused on serum IgG subclasses in Crohn's disease with resected bowel (11 patients) and without previous surgery for Crohn's disease (12 patients). All patients were in active stage of the disease on total parenteral nutrition. Serum IgG subclasses were estimated by means of radial immunodiffusion. There was no significant differences between in IgG subclasses in Crohn's disease with and without bowel resection. IgG2 over 4.5 g/l was found only in 2/12 with resected bowel and 1/11 without previous surgery for Crohn's disease. Surprisingly, IgG1/IgG2 ratio below 1.5 was found only in 5/23 persons. In 3/23 patients IgG1 was over 10.5 g/l although there was no doubt about the diagnosis of Crohn's disease. IgG subclasses failed to help in confirmation of the diagnosis of Crohn's disease. Serum IgG subclasses alterations probably are not influenced by bowel resection and/or nutritional status.

Adolescent↗

PubMed1993

Surgical treatment of pulmonary artery primary myxosarcoma.

Case of the 47-year-old man, clinically suffering from recurrent dyspnoea, cough, syncopes, haemoptysis, unsuccessfully treated with anticoagulant and fibrinolytic agents, is described. Large masses of a tumour, occupying nearly the whole lumen of pulmonary artery and extending to peripheral branches, were removed during surgery. The tumour was histologically and immunohistochemically classified as myxosarcoma. Following surgery, the patient was asymptomatic, could do his original job (lorry-driver) for the next 14 months. He died 20 months after surgery, showing symptoms and signs of progressive right heart failure. At autopsy, the tumourous obliteration of the pulmonary artery and adjacent thrombosis were found. Primary pulmonary artery sarcoma should be considered in the differential diagnosis of recurrent pulmonary thromboembolism, especially when no peripheral vein thrombosis could be found.

Humans↗

PubMed1991

[Predictive value of indicators of oxygen supply to tissues in patients with chronic obstructive lung disease].

The authors investigated in a group of 83 patients with chronic obstructive pulmonary disease the prognostic impact of some indicators of pulmonary function, haemodynamics and oxygen transport. They demonstrated that the prognosis is less favourable in patients with a lower one-second vital capacity with a higher median pressure in the pulmonary artery, with a lower oxygen tension in the arterial blood and higher haemoglobin concentration. They did not reveal significant differences between those who died and those who survived for more than five years, after the examination, as regards oxygen supply of tissues, oxygen consumption, coefficient of oxygen extraction and values of oxygen tension in mixed venous blood. Oxygen inhalation led to an increased oxygen supply of tissues and increased oxygen tension in mixed venous blood to normal values in all examined groups. This observation may be one of the explanations of the more favourable prognosis of patients with respiratory insufficiency, associated with chronic pulmonary obstructive disease, who have permanent oxygen therapy during domiciliary care.

Biological Transport↗

PubMed1990

Changes in pulmonary and systemic haemodynamics after the administration of various vasodilators in patients with pulmonary hypertension.

The authors investigated the influence of some vasodilatory drugs on pulmonary and systemic haemodynamic parameters in 69 patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease (with the exception of two patients with diffuse pulmonary fibrosis and one patient with recurrent pulmonary thromboembolism). The investigated vasodilatory drugs were as follows: Dihydralazine Spofa--8 patients, Corinfar--10 patients, Ketanserin--13 patients, Nit-Ret 7 patients, Nitroglycerin Spofa--10 patients, Nitro-Mack--11 patients, Iso-Mack retard--10 patients. The haemodynamic parameters were measured before and at various time intervals after the administration of the vasodilatory agent (Dihydralazine 50 mg perorally--30th and 60th minute, Corinfar--20 mg sublingually--60th minute, and in 7 patients following a 6 months period of 30-60 mg Corinfar daily dose, Ketanserin--10 mg intravenously--10th, 20th and 40th minute, Nit-Ret--2.5 mg perorally--30th and 60th minute, Nitroglycerin Spofa--0.5 mg sublingually--10th and 30th minute, Nitro-Mack--1 mg intravenously--immediately following the end of a slow i. v. infusion for 20 minutes, Iso-Mack retard--20 mg perorally, 60th minute). The blood gases were measured at the same time intervals, too. The results in various groups were as follows: Dihydralazine administration was not followed by any significant change in PAP, CO, PVR, while a significant decrease in AOP and SVR was ascertained. A significant decrease of PaCO2 and no change in PaO2 were measured. Following Corinfar administration, no change in PAP, CO or PVR and a significant decrease of PaCO2 and no change in PaO2 were measured. Following Corinfar administration, no change in PAP, CO or PVR and a significant decrease in AOP were determined. No significant changes in blood gases were measured. Following a 6 month Corinfar treatment period in 7 subjects, no significant changes in pulmonary haemodynamics or blood gases values were found. No clinical benefit of this drug could be estimated. Ketanserin administration was not followed by any changes in pulmonary haemodynamics, whereas a significant decrease in AOP and SVR were found. The administration of Nit-Ret was followed by a significant decrease of CO, whereas no changes in PAP, AOP or PVR and SVR were found. No significant changes in the blood gas tenses values were measured. The administration of Nitroglycerin Spofa was followed by a significant decrease in RAP, PAP, AOP, RVEDP as well as in CO. No significant changes in blood gases were observed. The application of 1 mg Nitro-Mack intravenously was followed by a significant decrease in RAP, PAP, AOP and CO.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1989

[Long-term study of disorders of heart rhythm in patients with chronic diseases of the respiratory system].

The authors investigated the incidence of arrhythmias by the method of continuous recording of ECG tracings according to Holter in 16 patients with chronic respiratory diseases three times in the course of two years. The incidence of arrhythmias was very frequent, more serious disorders (class 3 or a higher class according to Lown's classification) were very rare. The authors provided evidence of a great variability in the incidence of arrhythmias in the same patients during different periods of investigation. They did not reveal a relationship between the incidence of arrhythmias and the degree of functional affection of the lungs, the severity of hypoxaemia and the drop of the maximum aerobic capacity of the lungs. They did not find a relationship between the incidence of arrhythmias and the pressure in the pulmonary artery, or the size of the right or left ventricle or the thickness of their wall. The authors do not consider the finding of arrhythmias in patients with chronic lung disease an unequivocally serious finding, as reported sometimes in the literature.

Adult↗

PubMed1987