Polish medical sciences and history bulletin最新文献

Using cytoenzymatic methods the activity of acid and alkaline phosphatase, non-specific esterase and glycogen content in peripheral blood cells were analyzed. A statistically significant rise in the activity of these enzymes was demonstrated in granulocytes and lymphocytes and a low level of glycogen in lymphocytes. Following prednisone treatment a statistically significant decrease was observed in the activity of studied enzymes and a rise in glycogen content.

Total hydroxyproline excretion in 24-hour urine was determined in 20 cases of systemic lupus erythematosus (SLE) before and during treatment. Additionally the excretion of hydroxyproline was determined in 14 patients receiving steroids for various other diseases (endocarditis, thrombocytopenia, acute leukemia, apofocal polyarthritis, ischialgia, spastic bronchitis, pleuritis and Dressler's post-infarction syndrome). The normal hydroxyproline value was established in 40 healthy persons. The normalization of pathologically increased hydroxyproline excretion in patients with SLE during treatment with prednisone in doses from 1.0 to 1.35 mg/kg/daily was associated with remission of clinical symptoms. Large doses of prednisone in pathological processes not primarily affecting connective tissue increased the 24-hour excretion of hydroxyproline and small doses of prednisone had no effect on hydroxyprolinuria.

The investigations were carried out in 296 patients with myocardial infarction (238 men and 58 women) aged 24-91 years, admitted to an intensive care unit on the 1st or 2nd day of the disease. In all patients the catheter for determination of central venous pressure was introduced into the right atrium through the cephalic vein the the first 100 cases, and through the subclavian vein in 196 cases. The catheter was kept in the atrium for 3-4 days. Values of c.v.p. between 50 and 120 mm Hg were accepted as normal.

A logical dendrite was designed for establishing indications for immunosupressive treatment; it was applied in a group of 51 patients with rheumatoid arthritis. A nomogram was constructed for calculation of the expected therapeutic result, on the grounds of the indications, proposed duration of treatment and drug dosage. Comparison of the calculated and actual clinical results of treatment showed that in over 80% of cases the actual results were either consistent with or better than the expected ones. The application of prognostication seems to be particularly useful in the case of long-term treatment with highly toxic agents.

In 20 cases of adult-type diabetes and in 10 healthy controls insulinemia, glycemia and free acids concentration were determined under basal conditions, after glucose load and after administration of inderal and glucose. After intravenous injection of inderal basal insulinemia fell in controls but this fall was statistically not significant, while in diabetics no evident changes of insulinemia were observed. Following inderal injection and oral glucose a statistically significant drop in insulinemia was observed in controls but not in diabetics. In both groups inderal injection was without any significant effect on glycemia before as well as after glucose load. In both groups a significant decrease occurred in the level of free fatty acids and inderal had no effect on it.

In 16 patients with chronic myelocytic leukemia an attempt to retard the myeoblastic transformation was carried out by means of repeated BCG administration in the period of remissions resulting from chemotherapy. Vaccinations were repeated at intervals of 4 weeks with doses of 2 mg of Mycobacteria by scarification. The time of uninterrupted remissions maintained with BCG vaccinations only ranged from 2 to 28 months, on the average 7.4 months. In this group 2 patients died and the duration of follow-up in the remaining cases ranges from 16 to 106 months, average 43.5 months. The survival time in the group of 16 patients with the same disease, who died after treatment with cytostatics only, was shorter ranging from 12 to 83 months, 32 months on the average. In one patient BCG vaccination was followed by tuberculosis of a supraclavicular lymph node.

In two cases of hepatic coma following advanced liver cirrhosis exchange transfusions were applied with plasmapheresis. In both cases the general condition of patients improved and consciousness returned. After exchange transfusions with plasmapheresis the serum levels of bilirubin, urea and ammonia decreased. Using appropriately selected fluids for erythrocyte suspension it is possible to affect selectively protein depletion and depletion of plasma blood clotting factors.

On the basis of the investigations performed it was shown that cryoapplication of the cornea by the original Krwawicz's method influences temporarily the proliferative and migratory ability to epithelial and endothelial corneal cells in tissue culture. The endothelium is more sensitive to the action of low temperature and recovers its normal dynamics of growth 10--12 days after application of cold while the epithelium requires for this only 4--5 days. The ability of migration, DNA synthesis and mitosis in conditions of tissue culture of the corneal epithelium and endothelium, after their exposure to low temperature, are not abolished, but they are suppressed for a longer period than the duration of the described histopathological lesions.

Thirty-two patients, 28 women and 4 men aged from 17 to 57 years were treated surgically for obesity. Their body weight ranged from 90 to 184 kg, with an excess weight from 42% to 180%. In 6 cases the Salmon operation and in 26 the Payne-de Wind operation were performed. Two patients died. In the remaining cases the postoperative course was uneventful and relatively mild. The longest follow-up period was 22 months. Weight loss rate was highest in the first period after the operation and the monthly rate of the weight loss in the first year after the operation was 3.5 to 6 kg. Diarrhea disappeared usually after 4 months. In some patients a transient fall in serum potassium and calcium level was observed. Other favorable results included a significant fall in the serum levels of cholesterol and beta-lipoproteins and improved value of BSP retention test. The condition of the patients is good and they have returned to work.

In 40 patients with carcinoma of the larynx transformation of lymphocytes under the influence of PHA was studied. In 20 patients, in addition, venous blood flowing from the tumor, collected during the operation was also examined. In 33 patients the index of blastic transformation was lowered as compared with that in the control group. In 15 of 20 patients, the lymphocytes of venous blood from the vicinity of the tumor showed significantly higher indices of blastic transformation in comparision with those from peripheral blood. It was assumed that difference was due to an increased participation of T-lymphocytes in venous blood flowing from the tumor area. T-lymphocytes might move into the blood from the lymphoid infiltrates which accompany the neoplastic tissue.