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Biomedical subjects

M Zichová

Publications and source records attributed to M Zichová.

At least 19 recordsLinked to original sources

[Dynamic bone scintigraphy in the diagnosis of renal osteopathy].

UNLABELLED: A study was undertaken to assess types of RO by a dynamic modification of osteoscintigraphy 53 pts dialyzed for 27-75 mths, 19-52 yrs old were divided, according to histological bone pictures, into 4 groups: I) 11 pts with hyperparathyroidism, II) 12 pts with osteomalacia, III) 11 pts with mixed RO, IV) 11 pts were after parathyroidectomy (PTE) and 13 controls. INVESTIGATIONS: the rate of 99mTc-Sn-HEDP accumulation in the skeleton, skeletal/background radioactivity index both registered for 60 min. (parameters K and P), serum levels of C-PTH, bone isoenzyme of alkaline phosphatase (bALP), acid phosphatase (ACP), free hydroxyproline (S-Hypro). RESULTS: 1. compared to controls: elevations of K and all biochemical parameters, P in groups I and III (p < 0.01 - < 0.001) were found. 2. Group 1 was characterized by the highest values of all parameters compared to groups II and IV (p < 0.01). 3. Linear relationships were found between K and bALP (p < 0.01), P and bALP, ACP, S-Hypro (p < 0.01) in pts of groups I, II, III. 4. PTE in group IV was followed by a decrease in all parameters (p < 0.01) compared to values of the same pts in group I. Aluminum osteopathy was present in 2/3 of cases in group II showing the lowest values of all parameters. CONCLUSION: DBS is a sensitive method for assessing bone turnover rate according to the degree of skeletal uptake of radionuclide. In this manner it is possible to determine both the type of RO and it's further development in repeated measurements.

Adult↗

[Changes in plasma renin and aldosterone after parathyroidectomy in patients with hyperparathyroidism].

The plasma renin activity and its changes after parathyroidectomy indicate a preserved internal secretory renal function in dialyzed patients. The PRA values before parathyroidectomy are not unequivocally related to the blood pressure reading. After parathyroidectomy during the initial months the renin and aldosterone plasma levels decline in patients with secondary and primary HPT (p < 0.001), the urinary Na/K quotient rises in primary HPT (p < 0.05) and the systemic blood pressure declines in dialyzed patients with secondary HPT (p < 0.001). The findings suggest relations between the two hormonal systems during hyperparathyroidism and in the early stage after parathyroidectomy. Parathormone probably stimulates renin secretion. After a prolonged time interval following operation the parathormone levels in the blood steam reach normal levels and the same probably applies to intracellular calcium in cells of the iuxtaglomerular apparatus along with PRA.

Adult↗

Assessment of alpha-fetoprotein in chronic HBsAg carriers and in HBsAg negative cirrhosis of the liver.

Alpha-fetoprotein (AFP) was assessed in 159 subjects with chronic liver disease, incl. 125 chronic HBsAg carriers (42 suffered from cirrhosis of the liver) and in 34 HbsAg negative cirrhotic patients. In the group of 83 patients with chronic hepatitis B a slightly elevated AFP value was recorded in 7.2%, however, during the check-up examination it was already normal. During a one-year follow up hepatocellular carcinoma (HCC) was revealed in 4 of 42 HBsAg positive cirrhoses (9.5%) and in 2 of 34 (5.9%) HBsAg negative cirrhoses, the difference was not, however, significant. Five patients with HCC had markedly elevated or rising AFP value, one patient had abnormal AFP level despite advanced HCC. All cases of HCC were diagnosed late, in one patient radical treatment was not successful. We conclude that to improve the adverse prognosis of patients with HCC it is necessary to follow-up prospectively all patients with cirrhosis of the liver by sonography twice a year and examine after the same time intervals serum AFP to detect early stages HCC where there is still some chance of successful treatment.

Adolescent↗

Prevalence of HBeAg and HBsAg seroconversion in patients with chronic hepatitis B.

In 37 patients with chronic hepatitis B in the stage of active viral replication the authors tried to assess the time of seroconversion of HBeAg to anti-HBe and HBsAg to anti-HBs (21 men, 13 women and 3 boys, mean age of adults 44 years). During the 8-years investigation period seroconversion of HBeAg occurred in 19 of 37 patients (51.3%) which is an annual rate of seroconversion 6.4%. HBeAg disappeared from serum after a mean period of 82 months (range 29-228 months). After seroconversion of HBeAg the ALT and AST activity declined significantly. Acute exacerbation of hepatitis before seroconversion of HBeAg was recorded in 13 of 37 patients (35%). The mean ALT activity at the peak of exacerbation was 7.93 mu kat/l, the average duration of exacerbation was 9.8 months. Seroconversion of HBsAg occurred in 7 of 37 patients (19%). The mean annual rate of seroconversion of HBsAg was 2.4% after an average period of 98 months. During the investigation period 7 patients died (19%), four of them had a constantly positive HBeAg. The authors conclude that very low annual average seroconversion of HBeAg (6.4%) and HBsAg (2.4%) in patients with chronic hepatitis B is probably caused by previous glucocorticoid treatment.

Adult↗

[Hyperparathyroidism and parathyroidectomy in dialyzed patients].

The authors present older and more recent views regarding the pathogenesis of hypocalcaemia and secondary hyperparathyroidism in patients with chronic renal failure with emphasis on the impact of inorganic phosphate retention and lack of 1,25-dihydroxyvitamin D3 in body fluids. As regards therapeutic procedures the initial problem is to control hyperphosphataemia and to suppress the increased parathormone secretion in particular in dialyzed patients. When treating hyperphosphataemia it is necessary with regard to the severity of the finding to use concurrently several procedures and avoid aluminium phosphate binders. Aimed reduction of high parathormone levels in the blood stream can be achieved by medicamentous--pharmacological means, using 1,25 (OH)2 D3 or surgery of the hypertrophic parathyroid glands. The term parathyroidectomy can comprise also percutaneous infiltration of the parathyroid glands with ethanol. From this aspect under certain circumstances a combination of different therapeutic procedures may prove useful. In the conclusion the authors mention basic data on para-thyroidectomies performed in their department: the favourable long-term results of operations amounted to 80.4%.

Humans↗

[Determination of bone mineral content in vivo in dialyzed patients using photon radiation absorptiometry].

In a group of 47 women and 54 men with chronic renal failure included in a regular haemodialyzation programme the mineral content of bone was assessed using the method of radiation absorption of the radioisotope americium (241Am) on a Bone mineral detector of Gambro Co. The bone mineral content was reduced in men and women by 22%, as compared with healthy subjects of the same age and sex. The reduction was more marked in patients dialyzed for longer periods and when there were lamoratory signs of activity of the process.

Absorptiometry, Photon↗

[Are there abnormalities of parathormone, calcium and phosphorus metabolism in hypertrophic cardiomyopathy?].

The importance of calcium and phosphorus metabolism for the development of hypertrophic cardiomyopathies is still obscure. Therefore 52 patients with hypertrophic cardiomyopathy were subjected to detailed cardiological and laboratory examinations. Twenty-five age matched healthy subjects served as controls. The following indicators were assessed: calcium and its ionized fraction, phosphorus, chlorides and magnesium in serum and 24 h urine, as well as AST, ALT, ALP, ACP, urea, creatinine, protein electrophoresis (to check calcium values with regard to serum albumins), endogenous creatinine clearance, Palmer's chloride phosphate index and Nordin's index. In addition to tubular phosphate reabsorption, the renal phosphate threshold was assessed and finally the parathormone blood level by the RIA method. In patients with hypertrophic cardiomyopathy a significant increase of the parathormone level was found--in a total of seven patients with advanced myocardial hypertrophy (more than 30 mm). There were no significant differences in the remaining parameters. It may thus be admitted that in some instances the increased parathormone level may cause an increase of the already existing myocardial hypertrophy. However, in the broad spectrum of patients with hypertrophic cardiomyopathy it is not suited for explaining morphological findings.

Adolescent↗

[Clinical importance of the determination of specific HBsAg and IgM class antibody complexes in acute viral hepatitis B].

In a group of 10 patients with acute viral hepatitis type B in 1985-1988 repeatedly RIA and IRMA estimations of specific signs of infection were made. Concurrently the sera were examined for the presence of a new "marker"--complexes of HBsAg with a class IgM antibody. Detection of these complexes in serum is of diagnostic and prognostic value, in particular when dynamic changes in the course of time are investigated.

Acute Disease↗

[Metoprolol and metipranolol in the treatment of hypertension-- comparison of the effects of a single dose and administration for 1 month].

In six subjects the hypotensive action of metoprolol (Betaloc, Egis) after a dose of 166.7 +/- 47.1 mg and metipranolol (Trimepranol, Spofa) 21.7 +/- 3.7 mg was investigated. Betaloc influences after one month's administration the systolic blood pressure more effectively in a recumbent position and upright position and the diastolic pressure in a sitting position and after walking. The authors investigated also indicators of the circulation, blood sugar values, values of immunoreactive insulin, aldosterone and plasma renin activity after a single dose of 10 mg Trimepranol or 100 mg Betaloc. Betaloc caused a significant drop of the systolic blood pressure already after 15 minutes, Trimepranol after 30 minutes, in both instances the maximum effect was recorded after 45 minutes and persisted throughout the six-hour investigation. The diastolic blood pressure and heart rate were influenced only little. The blood sugar levels after Betaloc rose significantly during the first hour, after both drugs during the third hour. No correlation was found between changes of the blood sugar level and immunoreactive insulin levels. No differences were revealed as regards the effect on plasma renin activity and aldosterone levels.

Blood Pressure↗