[Incidence of pancreatic carcinoma in persons with chronic pancreatitis]. / Incidence pankreatického karcinomu u osob s chronickou pankreatitidou.

INTRODUCTION: Pancreatic carcinoma is one of the diseases which mostly fail to be diagnosed on a timely basis, and there is no way to effectively screen patients for pancreatic carcinoma either. An option for the diagnosis of the "early glandular carcinoma" therefore resides in identification and systematic screening of patients with risk of pancreatic carcinoma. METHOD: We monitored 223 patients with chronic pancreatitis on a systematic basis from 1992 to 2005. During this 14-year period, we monitored the number of cigarettes smoked per year in addition to standard parametres measured by biochemical methods, endosonography, CT and ERCP exams, and assigned the alcoholic form of chronic pancreatitis to patients consuming more than 80g of alcohol per day on a systematic basis for more than 5 years in the case of men, and 50 g of alcohol per day in the case of women, and classed the patients according the TIGARO classification. RESULTS: Alcoholic etiology was proven in 73.1% of the examined patients, chronic obstructive form of pancreatitis was diagnosed in 21.5% of patients, and only 5.4% of patients were classified into the idiopathic pancreatitis group. Pancreatic carcinoma in the region of chronic pancreatitis was found in 13 patients (5.8%); stomach carcinoma was diagnosed in 3 patients with chronic pancreatitis, and oesophageal carcinoma in 1 patient of the total of patients monitored. Malignant pancreatic disease was diagnosed primarily in patients with alcoholic pancreatitis (4.5%). During the period of 14 years, 11 patients died, 8 of the deaths being associated with pancreatic carcinoma. CONCLUSION: Both pancreatic and extrapancreatic carcinoma in gastrointestinal location is a serious complication of protracted chronic, non-hereditary pancreatitis. Systematic identification and treatment of patients with chronic pancreatitis is therefore necessary for timely diagnosis ofgastrointestinal and pancreatic malignancies.

Separation of H(2)SO(4) + CuSO(4) mixture by diffusion dialysis.

Diffusion dialysis of aqueous solution of H(2)SO(4) + CuSO(4) has been investigated in a two-compartment cell with an anion-exchange membrane Neosepta-AFN. The experiments have proved that sulfuric acid permeates well through the membrane used, while cupric sulfate is efficiently rejected. This operation is very effective at high acid concentrations and low concentrations of cupric sulfate. Furthermore, it has been found that even at the highest concentration of CuSO(4), the rejection coefficient is higher than 0.965. The flux of CuSO(4) calculated from the time dependences of the CuSO(4) concentration is negatively influenced by increasing acid concentration.

[Problems due to workload after surgical treatment of carpal tunnel syndrome]. / Problematika pracovní záteze po operacním resení syndromu karpálního tunelu.

The authors present a group of patients operated on account of the carpal tunnel syndrome in 1998-2000 at the Neurosurgical department in Pardubice. The group comprised 37 patients. 15 men and 22 women. The main objective of the retrospective investigation was to assess the period of work incapacity and asset of the operation from the aspect to proceed with the usual workload. The authors also tried to evaluate the effect of age, sex, occupation, preoperative clinical and electromyographic finding on the resulting effect of the operation. The period of work incapacity after one operation was 114 days. 84% patients returned to their original job. In 11% it was necessary to enlist in different work and a disability pension was granted to 5% patients. The discussion is focused on the period of work incapacity, enlistment in work, the effect of operation on the patients complaints and the objective finding as regards the lesion of fibres of the median nerve and also on the asset of EMG in the diagnosis and postoperative follow up.

[Zinc and copper in diseases of the digestive tract] ]. / Zinek a med' a nemoci trávicího traktu.

The author mentions the basic metabolic functions of zinc and copper in the human organism. She emphasizes the relationship of serious diseases, congenital and acquired, associated with deficiency or excess of these mineral trace elements. As to inborn diseases, we encounter most frequently Wilson's disease in impaired copper metabolism, rarely morbus Danbolt in congenital impairment of zinc absorption. In practice we are faced in particular with secondary causes of impaired zinc or copper levels, e.g. in chronic diarrhoeal conditions, coeliac disease, chronic pancreatitis and others.

[Nutritional profile and treatment of subjects with chronic pancreatitis]. / Nutricní profil a terapie u osob s chronickou pankreatitidou.

The authors give an account on the nutritional status of patients with chronic pancreatitis according to the Cambridge classification of ERCP changes grade II and III, treated conservatively and by surgery. From a perspectively followed up group of 30 patients with chronic obstructive pancreatitis before surgery 53.5% suffered from malnutrition. Nine months after surgery the nutritional status improved in 9 of 16 patients, malnutrition persisted in 23.3%. During a check-up examination 3 years after surgery and despite dietetic treatment and enzyme substitution 20% patients suffered from malnutrition. In some of the patients low zinc and magnesium serum levels were found. In a group of 17 patients treated conservatively malnutrition was recorded in 41.2% patients. After modification of dietetic treatment and enzyme substitution the nutritional status improved but during a check-up after 9 months 23.5% patients remained malnourished. The authors analyze the causes of development of malnutrition and possibilities of its therapy.

[Percutaneous endoscopic gastrostomy in nutritional therapy--personal experience]. / Perkutánní endoskopická gastrostomie v nutricní terapii--vlastní zkusenosti.

The authors have described the indications, contraindications of percutaneous endoscopic gastrostomy (PEG) and its consecutive nutritional possibilities. They have described their own experience with 11 patients. Most common indications for the placement of a gastrostomy tube were neurological, and only in one case, esophageal diverticle. The average duration of PEG was 102 days (2-732). Besides PEG, not only polymeric diet, such as Nutrison standard sol, Fresubin, Salvimulsin, was administered, but also home-made diet, for example, mixed soup, mashed potatoes, yoghurt, juice and cocoa. The diet prepared at home was tolerated well, except for subjective data about meteorism given by one female-patient. PEG complications were minimal, in one case a dry fistula was detected after the extraction of PEG; it was closed spontaneously a week later. Another female-patient showed leukocytosis and hyperpyrexia, the etiology of which could not be proved. The patient was treated symptomatically, and three days later, leukocytosis and hyperpyrexia were normalized. A patient who has had the gastrostomy tube placed for two years, showed secretion which was treated symptomatically; now the patient is without any complications. In the last patient, there was detected an inflammation around the fixation base. Although she was treated with H2 blockers, the condition has not been improved. The authors have recommended this method in correct indications as a considerate alternative application of enteral nutrition.

[Anti-HCV positivity in blood donors]. / Pozitivita anti-HCV u dárcu krve.

At the blood transfusion department of the Faculty Hospital in Olomouc in 1992 and 1993 18,293 blood donors were examined and in 70, i.e. 0.38% anti-HCV positivity was found. All positive subjects were subjected to clinical, laboratory and sonographic examination and are checked regularly at the Second Medical Clinic. In none of the patients liver biopsy was performed so far. The clinical, laboratory and sonographic findings provide evidence of liver damage in 15, i.e. 21.4%. In two of them, i.e. in 2.8%, the findings support the diagnosis of chronic active hepatitis; this will be verified by biopsy. The authors consider dispensarization of anti-HCV positive subjects useful. In all examination of RNA HCV however must be made.

[Asymptomatic HBs antigenemia in pregnant women]. / Asymptomatická HBs antigenémie u gravidních zen.

The authors have dispensarized for more than ten years HBsAg carriers at the Second Medical Clinic of the Olomouc Faculty Hospital when antigenaemia was detected during blood donorship. Since 1990 the authors dispensarize also women where HBs antigenaemia was revealed during pregnancy. In the presented paper the authors analyze this group of women. In 1990-1991 the authors examined blood samples for HBsAg from 12,042 symptom-free pregnant women. HBsAg positivity was proved in 34 women (0.28%). Eleven women (32.3%) are regularly followed up since delivery. The authors know nothing about the fate of 10 women (29.4%), as they did not respond to repeated invitations to the surgery. It must be however mentioned that 6 of them are Vietnamese and probably left Czechoslovakia. Four women (11.7%) did not attend the clinic for examination but the authors know that they were delivered of their babies elsewhere. In the remainder, i.e. 8 women the delivery was normal, usually in term. The neonates were passively as well as actively immunized at the appropriate dates. Their umbilical blood (if collected) was HBsAg positive, while the venous blood was in all instances negative. All 20 women who attended examination were throughly examined (ultrasound, HBeAg, HBeAb etc.) and the clinical picture is that of a "healthy" HBsAg carrier (not verified by histological examination).

[Diagnosis and therapy of post-infarction cardiac complications]. / Príspevek k diagnostice a lécbe poinfarktových srdecních komplikací.

The authors discuss the diagnosis and treatment of acute myocardial infarct complications. They describe a rare combination of these complications: interventricular septum rupture and left ventricular aneurysm with envelope perforation, filled by a thrombus.

[Relation between echocardiographic indicators and beta 2-adrenergic receptors in essential hypertension during treatment with enalapril]. / Vztahy mezi echokardiografickými ukazateli a beta 2-adrenergními receptory u esenciální hypertenze v prubehu lécby enalaprilem.

A group of 22 men with essential hypertension stage I and II according to WHO, mean age 29.1 +/- 1.4 years, was divided at random into two sub-groups. Eleven patients were treated for four weeks with enalapril (E), 10 mg/day, 11 patients were given placebo (P), also for a period of four weeks. The patients were subjected to echocardiographic examination before and after four-week therapy with enalapril or placebo. In patients treated with E a significant reduction of the left ventricular wall and the interventricular septum was observed. There was also a highly significant decline of the weight of the left ventricle and the index of left ventricular mass. Enalapril led to a decline of the specific binding capacity and affinity of beta 2-adrenergic lymphocyte receptors. In the group given P no differences were found during the examination repeated after four weeks. By means of multidimensional linear regression estimates a close relationship was revealed between the difference in the weight of the left ventricle, the difference of the index of left ventricular mass and the difference of specific binding capacity and affinity of beta 2-adrenergic lymphocyte receptors.