Vnitr̆ní lékar̆ství
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Vnitr̆ní lékar̆ství · Jan 1999
Review[Cell adhesion molecules and their role in pathophysiologic processes].
Cell adhesion molecules are substances with a protein character expressed on the cell surface of all tissues. They participate in the control of basic vital processes, in processes of embryogenesis, cellular growth and differentiation, they ensure the interaction of cells with the environment. At present four main classes of cytoadhesion molecules are known: integrins, the immunoglobulin group of adhesion molecules, cadherins and selectins. ⋯ In case of damage or inflammatory processes of the blood vessels due to the action of released cytokines increased expression of adhesion molecules of the integrin, selectin and immunoglobulin groups occurs and subsequently increased adhesion and migration of inflammatory cells across the vascular wall. Impaired function of the vascular endothelium is also the first step in the genesis and development of chronic vascular disease--atherosclerosis. In the initial stage of development of atherosclerosis--during rolling, adhesion and migration of leucocytes across the endothelium the cytoadhesion molecules play a crucial role.
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Vnitr̆ní lékar̆ství · Jun 1997
[Kinetic analysis in the evaluation of glucose tolerance disorders. Evaluation and use of a new method in the diagnosis of glucose tolerance in clinical practice].
A kinetic model of oGTT has been used. This model is characterized by 7 glycaemia collections (0, 30, 45, 60, 120, 180 min). In some cases this is supplemented by determination of C-peptide and insulin values (0, 60, 120 min). ⋯ Over 1/5 of persons with impaired tolerance for glucose according to the classical oGTT was found by the kinetic model to have diabetes mellitus. On the contrary, 1/10 of diabetic patients diagnosed by oGTT had normal glucose clearance, over 1/2 of patients had only impaired glucose tolerance. Then in 126 persons random error of the method was again calculated (> 2,000 repeated calculations for each proband) amounting 6.6%.
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Vnitr̆ní lékar̆ství · Jan 1997
Clinical Trial Controlled Clinical Trial[Interferon-alpha in the treatment of patients with chronic myeloid leukemia].
A retrospective analysis of the treatment with Interferon alpha in 18 patients with Ph positive chronic myeloid leukaemia is presented and compared with the results of peroral chemotherapy with Hydroxyurea or Busulphan in 20 patients. Patients treated with Interferon were significantly younger than the control group (median age 40.5 versus 55.5) (p = 0.01) and were followed-up for shorter period of time (median 10.5 months versus 36.5 months) ( p = 0.002), but did not differ in other parameters. ⋯ In general, our short-term results confirm the importance and effectiveness of Interferon in the patient with CML providing the therapy was started early, with an effective dose and with simultaneous cytogenetic monitoring. Longer observation of the patients is needed to confirm the impact of Interferon on the survival of patients.
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Vnitr̆ní lékar̆ství · Dec 1996
[Methods of continuous extracorporeal replacement of renal function].
Methods of continuous renal replacement therapy are used to an increasing extent also in this country. The oldest one, continuous arteriovenous haemofiltration has been supplemented by continuous haemodialysis, hemodiafiltration and high-flux dialysis. An alternative of the arteriovenous vascular access is the veno-venous one. ⋯ So far it has not been proved that continuous methods are an asset in the treatment of conditions such as sepsis/septic shock, necrotizing pancreatitis, syndrome of acute respiratory distress (ARDS) and others, if the renal function is preserved. Problems of indication and comparison with intermittent procedures must be resolved in subsequent well planned studies. Problems which must be dealt with in future are technical innovations which will increase the effectiveness of the procedures, e.g. by making fuller use of adsorption, and problems of hemocompatibility, in particular in relation to the thrombogenicity of the extracorporeal circulation and the associated administration of anti-thrombotic drugs.