Polish medical sciences and history bulletin最新文献

On the basis of 3 cases of lymphoglandular toxoplasmosis recognized after biopsy of lymph nodes the authors established the clinical and morphological syndrome of this disease entity. Attention is called to the possibility of erroneous histological evaluation of the examined lymph nodes owing to the similarity of glandular toxoplasmosis to other diseases of the lymphatic system.

In 62 patients with chronic renal failure the concentration of total and ultrafiltrable magnesium in plasma water was significantly raised and showed a weak but significant correlation with the degree of renal failure expressed by serum creatinine concentration. Erythrocyte magnesium concentration increased significantly showing a more significant correlation with the degree of renal failure than the plasma magnesium level. The fluid used for dialysis contained 1.5 mEq/l of magnesium and this failed to prevent the rise of concentration of this electrolyte in the plasma and erythrocytes. A statistically significant positive correlation was demonstrated between the concentrations of magnesium and ultrafiltrable calcium in patients with creatinine concentration below 4 mg/100 ml.

In 15 severely burned patients the concentrations of sodium and potassium were determined in 605 urine samples. Concentrations of both electrolytes were reduced. A decrease in urinary sodium concentration below 10 mEq/l, persisting during several days, was an unfavorable prognostic sign. Low urinary potassium concentrations (below 10-20 mEq/24 hrs) were interpreted as an evidence of cellular potassium depletion.

Results of investigations on platelet adhesiveness in burned patients after the stage of shock were presented. In all cases studied (17 patients) the values of platelet adhesiveness were lower than in healthy subjects. Further investigations are required to explain this finding.

The application of peroxidase-labeled antiserum to human gamma globulin allowed the immunological reaction in vivo to be localized in the basement membrane, particularly in its part termed the lucid zone. The bulla is formed between the basal cell membrane and the dark lamina of the basement membrane.

In 5 patients with Cushing's disease the balance of nitrogen, potassium, phosphorus, sodium and chlorides was determined during 5 days before, and 10 days after bilateral two-stage adrenalectomy. The patients received substitute treatment with hydrocortisone in mean doses of 112 mg/24 hours after the first stage and 203 mg/24 hours after the second stage. After removal of the first adrenal the metabolic response of the cell mass and extracellular space was within the normal range of moderately intense responses. After the second adrenalectomy the cumulative balance of the components of the cell mass was slightly negative and retention of sodium and chlorides was more pronounced than after the first operation.

In 42 patients with chronic renal insufficiency the 24-hour magnesium excretion decreased with the progress of renal failure and was independent of the total and intrafiltrable magnesium concentration in the plasma. At the same time the fractional excretion of this ion increased progressively probably as a result of increased osmotic load acting on individual nephrons and/or the action of the natriuretic factor. The high correlation between fractional excretion of magnesium and sodium, and magnesium and calcium may suggest an interrelationship between the transport mechanisms of these ions in the nephron.

The effect of Imuran on experimental Masugi glomerulonephritis was checked in rabbits. The animals were grouped in biologically most similar pairs: one of the mates was treated with Imuran (4 or 8 mg/kg daily) the other served as control. Clinical and laboratory investigations were supplemented by histological and immunofluorescent studies of renal specimens taken on the 1st, 3rd, 7th, 10th, 21st, and 35th day of observation. The course of glomerulonephritis appeared much milder in Imuran-treated animals with a morphological counterpart in the form of reduced glomerular exudation and cellular proliferation. Only a slight and inconstant decrease of deposition of rabbit gamma-globulin and fibrin was observed in treatment animals in later stages of the experiment. Without denying a slight immunosuppressive effect, the authors admit that, in doses below 8 mg/kg daily, Imuran exerts a rather antiininflammatory effect on experimental glomerulonephritis.

The authors reported their own experiences with prevention and treatment of pulmonary complications developing in burn disease. In burn shock the most important problem is maintenance of a sufficient volume of circulating blood and cardiac output, and effective control of pain resulting from thermal injury. Later, the most important becomes prevention of infections and early mobilization of patients. It was demonstrated that physiotherapy, air humidification, lung expansion and inhalations of broncholytic and mucolytic drugs prevented effectively pulmonary complications. When severe respiratory disturbances developed, controlled respiration was successfully applied in 9 cases.