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Biomedical subjects

J Malý

Publications and source records attributed to J Malý.

At least 19 recordsLinked to original sources

[Familial juvenile gouty nephropathy].

The authors present the description of a family comprising father (his mother had died middle-aged from renal failure) and his two children aged 15 and 17 years who developed is young age (already in the second decade) gouty arthritis and primary interstitial nephritis. Based on the laboratory finding of hyperuricaemia with disproportionately low urate excretion and excretion of excessive uric acid formation, an enzyme defect and other renal disease the authors diagnosed familial gouty juvenile nephropathy. This diagnosis was confirmed also by histological examination of renal biopsy in the youngest member of the family. It is a disease which belongs into the group of hereditary types of nephritis. In the literature worldwide some nine families were described, in the Czech Republic it is the first description of this condition.

Adolescent

[Changes in platelet activity in invasive cardiologic procedures].

The authors revealed some changes in the platelet activity in patients with invasive cardiological procedures. Changes of the platelet function were manifested by an enhanced aggregation of platelets in vivo, an increased secretion from alpha granules and increased release of prostaglandin metabolites from platelets and from the vascular wall. Acetylsalicylic acid (ASA) suppressed the formation of circulating platelet aggregates in vivo, but the platelet activity was manifested by another mechanism, independent on ASA. The authors recorded therefore an increase of prostaglandin metabolites and PF4 even in patients who were treated with ASA before the invasive examination.

Angioplasty, Balloon, Coronary

[Changes in platelet function in patients with arterial hypertension].

The authors examined some indicators of platelet activity in patients with hypertension stage II (according to WHO). They revealed an increased platelet activity which was manifested by an increased concentration of platelet factor 4 (50.2 +/- 28.2 ng/ml) and thromboxane B2 (49.9 +/- 20.1 pg/ml) in plasma. The increase of indicators of platelet activation associated with hypertension is a molecular marker of activation of haemostasis and according to data in the literature it is an indicator of vascular complications in hypertension. It is not clear whether the increased platelet functions in hypertension is primary or an induced change.

Adult

[Bleeding time in incisions in patients with thrombocyte transfusion].

The authors used the Simplate test (Organon Teknika) to examine the bleeding time from an incision in 15 healthy blood donors and found normal values of 3.45 +/- 0.90 min. The authors proved a close correlation between the improvement of the number of platelets in 10 patients with thrombocytopenia, treated with thrombocyte infusions and the improvement of the bleeding time when using the Simplate R test after one hour and after 24 hours following thrombocyte administration. Examination of the bleeding time by means of the Simplate R test (Organon Teknika) was well tolerated by the authors' patients and the test does not produce any side-effects.

Adult

Migraine--a haematological disorder?

We analysed 22 patients suffering from migraine to evaluate the possible activation of platelet function utilizing the following methods: platelet factor 4, thromboxane B2 and 6 - keto prostaglandin F 1 alpha levels in platelet poor plasma. Laboratory tests were performed on all patients during headache-free period and the results obtained were compared with those of a normal healthy individuals. The mean results obtained in the patients group during pain-free period indicated a significant activation of platelet function when compared with the normal group.

6-Ketoprostaglandin F1 alpha

[Diagnosis and therapy of disseminated intravascular coagulation].

The syndrome of disseminated intravascular coagulation (DIC) is an acquired coagulation disorder which is characterized by a significant activation of haemostasis and the formation of intravascular microthrombi, the consumption of coagulation factors and activation of fibrinolysis. DIC has similar clinical stages and a similar laboratory picture, regardless of the causal factor. The diagnosis of DIC should be based on anamnestic, clinical and laboratory data. The laboratory diagnosis of DIC is possible by using relatively simple tests, which have the character of statim examinations. DIC treatment is based on the principle of treatment of the cause, discontinued consumption of haemostatic material, substitution of lacking factors and restoration of the microcirculation. The possible development of DIC must be taken into account in a number of acute conditions, in particular the development of shock syndrome. The presented article summarizes some views on causes, diagnosis and possible treatment of DIC.

Disseminated Intravascular Coagulation

[Actilyse (a recombinant tissue-type plasminogen activator] in the treatment of acute myocardial infarct. Comparison of the effects of Actilyse and streptokinase].

The preparation Actilyse--a tissue plasminogen activator prepared by recombination--is an effective fibrinolytic drug. The authors recorded in a group of 33 patients reperfusion in 91%, evaluated on the basis of indirect criteria. In a group of 18 patients treated with streptokinase reperfusion was achieved in 74%. Based on changes of CK and CK-MB values--an earlier rise of values following Actilyse administration and conversely their more marked increase during subsequent sampling after streptokinase administration--it may be assumed that earlier dissolution of the thrombus in the coronary artery occurs after Actilyse administration, as compared with streptokinase. It may be thus assumed that there is also a smaller necrotic focus after Actilyse treatment, as compared with streptokinase. Early re-occlusion--according to indirect indicators--occurred in 8.6% in the Actilyse treated groups, as compared with 5.9% in the streptokinase treated group. The fibrinogen values decline in the Actilyse group to 40% and in the streptokinase group to 28%. Later enhanced new formation of fibrinogen occurs and the fibrinogen values rise to 160% in the Actilyse treated group and to 250% of the initial value in the streptokinase treated group. The elevated fibrinogen value, as compared with the baseline value, persists for the 12 days of the follow-up. No severe spontaneous haemorrhage was recorded, haemorrhagic manifestations were associated with blood sampling and i.v. administration of drugs only. The necessity to administer blood was due to a complication during puncture of the subclavian vein in one patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

[Changes in blood pressure, proteinuria and renal hemodynamics in type I diabetes with manifestations of diabetic nephropathy after 2 months of captopril therapy].

In 15 type I diabetics with manifest diabetic nephropathy the authors investigated the antihypertensive and antiproteinuric effect of captopril and in seven patients of this group also its effect on renal haemodynamics. Captopril treatment or its combination with hitherto used antihypertensive treatment was associated after two months with a significant drop of the systolic and diastolic blood pressure from 150/95 (120/70-195/110) to 130/90 (110/65-180/115) mmHg, (p < 0.005 < 0.05). The median aortic pressure declined from 118.5 (92-140.8) to 106.5 (84-1334.8) mm Hg (p < 0.005). Nine of 11 patients (82%) could be changed to reduced antihypertensive therapy. The antiproteinuric effect was manifested in 11 patients (73%). Quantitative proteinuria dropped from 2.7 (0.83-8.65) to 1.85 (0.38-8.84) g/24 h., (p < 0.05) without a significant change of serum creatinine: 109 (70-342) vs. 135 (90-288) mumol/l, p = n.s.). The change of proteinuria, as compared with the baseline value, was -41 (-77 - +88)%, (p < 0.05) and did not correlate with the change of the median aortic pressure (correlation coefficient = -0.165, p = n.s.). In the group of seven patients the change of the median aortic pressure was -15% (-26.1 - +6.6), (p < 0.05). No statistically significant change of glomerular filtration was observed: 0.96 (0.32-1.38) vs. 0.96 (0.19-1.71) ml/s, p = n.s.); effective renal plasma flow: 6.32 (2.24-7.74) vs. 7.22 (1.68-10.55) ml/s, (p = n.s.); filtration fraction: 0.136 (0.123-0.220) vs. 0.130 (0.110-0.236), change 0.0 (-43.0 - +31.0)% (p = n.s.) and renal vascular resistance: 15429 (12907-54148) vs. 13243 (7099-77832)%, (p. = n.s.).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

[Treatment of the leukostasis syndrome in chronic lymphadenosis using leukapheresis].

The authors draw attention to the leukostasis syndrome which develops in haematological patients in case of enormous leucocyte proliferation. It occurs most frequently in chronic myelosis but may occur also in other types of leukaemia. The diagnosis is not easy. Most frequently disorders of the microcirculation develop in the lungs and brain. These are frequently very urgent clinical situations which can be resolved by leukapheresis. The authors described a patient where during chronic lymphadenosis proliferation of lymphocytes occurred to values of 1432 x 10(9)/l. After leukapheresis and cytostatic treatment rapid improvement of the condition occurred and the leucocyte values were approximately 30 x 10(9)/l. The patient's condition improved for a long period of time and became stabilized.

Humans

The platelet functions in stroke.

The share of platelets in the process of atherosclerosis and its thrombotic complications depends on the rate of their activation, which can be assessed by investigating the plasmatic levels of platelet factor 4 (PF4). Authors made use of this method in 68 patients with ischemic stroke and searched for the correlation between the found results, clinical picture and supposed etiopathogenesis of the disease. On the grounds of given findings they reached the conclusion that the increased PF4 levels represent no sign of a cerebral complication but only characterize the group of risky patients threatened by their platelets function status.

Blood Platelets

[Computer selection of thrombocyte donors based on the HLA system].

Thrombocyte concentrates are vitally important in thrombocytopenic types of haemorrhage. If repeated transfusions are necessary, they are associated with immunological reactions, which cause side-effects in the recipient and the transfusion is ineffective. Donors should be selected according to the HLA system. The authors prepared a programme in the Redap language for selection of donors according to HLA antigens (loci A and B) which respects cross reactions and split antigens. The donor is selected by the grade of agreement with the recipient. The authors differentiate between nine possibilities from complete agreement to complete disagreement between donor and recipient. The initial experience revealed that the programme is feasible for the user and is sufficiently quick.

Blood Donors

[The effect of pancreas and kidney transplantation on diabetic autonomic neuropathy].

The authors examined, using cardiovascular reflex tests, nine type I diabetics 6-48 months after combined transplantation of the pancreas and kidney with satisfactory function of both grafts. The control group was formed by 10 type 1 diabetics after transplantation of the kidney and 10 subjects free from disease causing damage to the vegetative nervous system. The results of the examination during the pretransplantation period suggested in both groups of diabetics severe affection of the vegetative nervous system. Despite long-term practical normalization of the diabetic metabolic disorder, in the patients after transplantation of the pancreas no detectable improvement of findings was recorded. Changes in the tests used were not found either in the control group of patients after isolated transplantation of the kidney. Damage of the vegetative nervous system in uraemic patients is probably irreversible and intervention studies are therefore indicated in an earlier stage of the disease.

Adult

[The significance of changes in fibrinogen levels during thrombolytic therapy in myocardial infarct].

The submitted work was concerned with two problems: a) investigation of the dynamics of changes of the fibrinogen and fibrin breakdown products after a single dose of streptokinase, b) evaluation of the effectiveness of thrombolysis from changes in the fibrinogen concentration. Two groups of patients were examined with the Q form of acute myocardial infarction who were treated at an intensive care unit. The first group comprised 62 patients (mean age 56.3 years) who were given 1 million units of streptokinase by the i.v. route. The second group comprised 52 patients who were given 1.5 million units of streptokinase. The authors investigated the fibrinogen plasma concentration and the fibrin breakdown product concentration in serum after 3-hour intervals. Concurrently they examined the creatine kinase curve. They proved a significant increase of the fibrinogen and fibrin degradation products before thrombolysis (p less than 0.001). The fibrinogen concentration declined in both groups highly significantly with a maximum after 12 hours. The fibrinogen level reached normal levels in both groups after cca 24 hours. Patients with a high initial fibrinogen level (above 5 g/l) did not attain hypofibrinogenic values during thrombolysis. This phenomenon did not depend on the size of the streptokinase dose. The decline of fibrin breakdown products in both groups declined to baseline values within 24 hours. The authors confirmed that the effectiveness of thrombolysis is influenced among others also by the residual fibrinogen value.

Female

[Preparation of thrombocyte concentrates in the Travenol CS-3000 separator (factors affecting the thrombocyte yield and presence of leukocytes)].

The authors made 184 thrombocytaphereses for the preparation of thrombocyte concentrates on a Travenol CS-3000 separator. They evaluate indicators on which the thrombocyte yield depends: it was found that the yield is higher in donors with a higher number of platelets and that it increases with the period of separation. The mean thrombocyte yield was 2.91 +/- 0.84 x 10(11). It corresponded to the average lower platelet number of donors--182 x 10(9)/L. In those donors where the number of platelets was higher than 180 x 10(9)/L, the yield was 3.21 x 10(9)/L. The undesirable presence of leucocytes (in 98% lymphocytes) increases in relation to the number of leucocytes in the donor and their decline after separation. It was lower in longer separations. The authors discuss the possibility to increase the thrombocyte yield without contamination with leucocytes.

Adolescent