Polish medical sciences and history bulletin最新文献

The results of the investigations of immunological reactivity in 120 surgical patients are presented. The direct lymphocytotoxicity test (DLT) was used. Negative results were found in only 20 patients; in the remaining 100, the number of damaged lymphocytes in the peripheral blood, examined in vitro was dependent on: 1) the type of surgical procedure (e.g. open reduction and internal fixation of long-bone fractures), 2) severity of surgical disease, 3) interaction of drugs used, and 4) infection, most probably viral. A high percentage of damaged lymphocytes was found firstly, in patients suffering from severe wound infections; secondly, in those with disorders of the peripheral arteries during the postoperative course and thirdly, in patients with advanced malignancy of the alimentary tract. The results of these investigations--regarded by the authors as a preliminary report--indicate that the DLT could be introduced routinely as part of pre- and postoperative examinations of surgical patients in order to evaluate their immunological reactivity.

The authors discuss the problem of quantitative changes in enterochromaffin cells in the rat small intestine after its extensive resection. An increase was found in the number of these cells in the peripheral part of the intestine 4 to 8 weeks after the operation. These quantitative changes are explained by the regenerative activity in this period.

Three cases of hypogammaglobulinemia are described. In all cases the first symptoms of disease manifesting as pneumonia were preceded by diarrhea. In gastric biopsy there was atrophic gastritis with lack of plasmocytes. All patients demonstrated gastric achylia and symptoms of malabsorption syndrome. The causes of gastrointestinal changes, most probably infections, with simultaneous defective mucosal barrier are discussed.

The results of investigations on the dynamics of immune reactivity are presented in 6 cases selected from 38 surgical patients. The investigations were carried out during surgical treatment of peripheral arterial diseases, malignant neoplasms of the alimentary tract, and extensive chronic inflammatory processes of the soft tissues. The evaluation of immune reactivity of these patients was based on the results of the direct lymphocytotoxicity test (DLT), the intensity of the autolymphocytotoxic reactions in the cold (15 degrees C) test, morphology and other changes of lymphocytes (various forms, lysis, leukergy) and on their ability to undergo blastic transformation in vitro after stimulation with PHA. The joint evaluation of investigations carried out repeatedly in these diseases may be useful for tracing the dynamics of immune reactivity in surgical patients.

In a group of 172 cases of polycythemia vera treated with radioactive phosphorus acute granulocytic leukemia developed in 3 and chronic granulocytic leukemia in 6 cases. The author believes that development of acute granulocytic leukemia during this treatment may be considered with some probability as a result of the leukemia-inducing action of ionizing radiation. Transition of polycythemia vera into chronic granulocytic leukemia seems to be a natural outcome of this complex myeloproliferative syndrome in patients with survival prolonged by treatment with 32P.

The frequency and type of affective disturbances developing in schizophrenia were evaluated and their relationship to the course of the disease and results of treatment was analyzed. The studied material comprised 67 patients with the diagnosis of schizophrenia, treated in hospital in 1973. The depressive and paranoid scores of Jaroszyński were used for evaluation of patients. Affective disturbances were found in nearly all cases, depressive symptoms being most frequent. The development or increasing intensity of depression could only partly be attributed to the action of neuroleptic drugs. No difference was found in the clinical pattern of affective distrubances between paranoid and cyclic schizophrenia. In the paranoid-depressive syndromes the best therapeutic results were obtained in cases with decreased complex activities and psychic inhibition. Neuroleptic drugs possessing some thymoleptic properties were used in treatment of these cases, sometimes in combination with tricyclic antidepressants. The results were in cases with significant anxiety, inhibition and depressive attitude towards the prevailing situation. Paranoid productive symptoms appeared in this group sometimes during treatment with tricyclic antidepressants.

In 12 patients with chronic hepatitis the carbohydrate tolerance and insulin secretion after intravenous and oral glucose loading were determined before and after lipostabil treatment. A significant rise of fasting insulinemia and hypersecretion of insulin after intravenous glucose loading were observed. After oral glucose loading the rise of insulinemia was significantly lower in patients than in healthy controls, despite a greater increase in glycemia. Administration of lipostabil for 2 weeks failed to exert any significant effect on carbohydrate intolerance and disturbances in insulin secretion, which were present in patients with chronic hepatitis.

Ultrastructural changes in the secretory lobe of rat hypophysis following bilateral adrenalectomy and a single subcutaneous administration of 1 i.u. of ACTH were studied. Both after adrenalectomy and ACTH administration, ultrastructural changes were found to appear exclusively in one type of secretory cells. After adrenalectomy, pictures were found in these cells indicative of increased synthesis of the secretory granulations. One hour after the administration of ACTH the ACTH-secreting cells showed features of decreased secretory activity.

The purpose of this work was to determine the influence of psychosis on the intellectual efficiency in psychotic patients. The scores obtained by schizophrenics tested according to the Wechsler-Bellevue scale were correlated with psychopathological symptoms established during psychiatric examination. The group included 55 patients (18 women and 37 men). The results were subjected to statistical analysis. The following correlations were disclosed: 1) a correlation between the results of Wechsler scale scores and sex as well as the educational level, 2) a more pronounced correlation between the presence of psychotic productions and the results of the performance scale (in relation to verbal scale), 3) higher variability of scores in the verbal scale than in the performances scale, 4) lack of correlation between the age, the age of onset and the results.

Investigations of the hemodynamics of pulmonary circulation, right and left heart venticle and ventilatory function of the lungs were carried out in a group of 12 patients with primary pulmonary hypertension. The results were discussed in the light of data obtained in a group of 16 patients with chronic cor pulmonale syndrome and 16 healthy subjects. It was found that patients with primary pulmonary hypertension show a markedly raised pressure in the pulmonary artery mean pressure x = 60.3 +/- 24.2 mm Hg, in the right ventricle (systolic pressure x = 90.6 +/- 27.9 mm Hg, end-diastolic pressure x = 11.7 +/- 4.3 mm Hg), very high total pulmonary vascular resistance (x = 1571 +/- dynes. sec. cm-5) and increased work of right ventricle (x = 2.3 +/- 1.5 kgm/min/m2). In patients with chronic cor pulmonale syndrome the load on the right ventricle was much lower. The indices determining left ventricle function as a pump indicated that this function was impaired, with lower cardiac index (x = 2.1 +/- 0.8 1/min/m2), stroke volume (x = 41.7 +/- 17.2 ml) and left ventricular work (x = 2.7 +/- 1.1 kgm/min/m2). These changes might, however, be due also to impaired blood flow into the left ventricle. In contrast to patients with chronic cor pulmonale syndrome, the indices of ventilatory function of the lungs were normal or only slightly decreased. No significant correlations were observed between hemodynamic indices of pulmonary circulation and right ventricle and the parameters of the ventilatory function of the lungs.