Sbornik vedeckych praci Lekarske fakulty Karlovy university v Hradci Kralove最新文献

Literature survey dealing with cholinesterases and effects of highly toxic organophosphorus compounds suitable for use as chemical weapons is given in introductory part of this work. There are nerve paralytical agents (NPA)--sarin, soman, VX and a model compound O-ethyl-S-(2-dimethylaminoethyl)-methyl-phosphonothioate (EDMM). On the base of described scheme of intoxication with NPA, inhibition effect on cholinesterases, preferably on AChE as the most important factor involved in the mechanism of acute intoxication with NPA was studied. Intoxication of mice or rats with sarin and soman (2 x LD50) showed that time course of poisoning is faster than that for VX or EDMM. Inhibition of AChE in the blood was in good correlation with symptoms of intoxication and also with inhibition of AChE in the brain. The differences between inhibition effect of soman preferably uniform character of inhibition in the brain parts) and sarin (selective inhibition in the brain parts, with maximum in the frontal cortex and pontomedullar area) were observed. This selectivity was most marked for VX and EDMM intoxication (maximal inhibition in the part of the pontomedullar area containing reticular formation). The dose causing inhibition effect in the brain was assessed to be about 1% of the dose administered. The study of the effect of antidotal therapy (combination of atropine and reactivator) in vivo showed in mice and rats intoxicated with sarin non-uniform increase of AChE activity in the pontomedullar part depending on the dose and type of reactivator. The most marked effect was observed for methoxime. It was demonstrated that there exists good correlation between survival of experimental animals and the rest AChE activity in the pontomedullar part of the brain. AChE activity level critical for survival or death of the organism poisoned with NPA was assessed from these experiments; it was about 1-5% of normal values. By means of original method allowing continual monitoring of AChE activity in the blood, similar AChE reactivation was demonstrated, with highest effect for trimedoxime and methoxime. Using continual determination of the blood AChE activity following sarin, soman, VX and EDMM intoxication demonstrated that only a part of the dose administered caused inhibition effect in the blood; this part was determined to be practically 100% (i. v. administration); for other routes of administration this ratio was as follows: 50-80% (i. m.), 20-40% (i. p.), 6-16% (p. o.) and 1-5% (p. c.), respectively. Using this continual monitoring, the detoxication of sarin and soman was demonstrated. Detoxication of VX and EDMM was not observed.(ABSTRACT TRUNCATED AT 400 WORDS)

From a large number of various embolic agents introduced in interventional radiology in last two decades it seems that an ideal embolic agent for intravascular embolization has not been found yet. The favourable properties of one of these agents - n-butyl 2-cyanoacrylate are presented by authors. It is concluded that the intravascular embolotherapy with n-butyl 2-cyanoacrylate performed in a strict accordance with the technical demands has proved to be efficient in the management of symptomatic arteriovenous malformations, in the percutaneous transhepatic embolization of gastroesophageal varices and in palliative embolization of renal tumors.

Effects of a three-month exposure of both male and female rats under their development to lead acetate in drinking water on the hypothalamus-pituitary gland-thyroid gland-suprarenals and sympathico-adrenal systems were evaluated by determining noradrenaline (NA) in the hypothalamus and striatum, thyroxine (T4), 3,5,3'-tri-iodothyronine (T3) and corticosterone (CS) in the serum and catecholamines (CA) in both blood and suprarenals. NA in the hypothalamus and striatum was decreased in exposed males. CA in blood and suprarenals and CS in the serum were increased and NA decreased in the hypothalamus and striatum in exposed females. No serum T3 and T4 changes were found in males or females. The exposure to lead resulted in increased weight of spleen and kidneys in both sexes and suprarenals in females only. Weights of hypothalamus, striatum, liver and thyroid gland did not change. Female rats exposed to lead grew more slowly than control animals. Retardation in the growth was not statistically significant in males. The results indicate a specific stress reaction in female rats. In males only the sympathico-adrenal system seems to be affected by such lead exposure.

In ergot alkaloids a disproportion between the size of the peroral dose and the achieved area under the curve concentrations was described. This process can be explained by nonlinearity in the absorption, distribution or elimination of alkaloids. The aim of the present paper is to find whether elimination of tritiated DH-ergotoxine (3HDHE) in the liver is a linear, dose-independent process. Therefore on the model of the isolated rat liver disappearance of radioactivity in perfusate after the administration of two doses of 3HDHE, viz. 60 ng g-1 of the liver and 3030 ng g-1 of the liver, was investigated. The disappearance curves of radioactivity expressed as the percentage of the administered dose did not significantly differ between both groups. No significant changes between the groups were found either in the size of pharmacokinetic parameters, or in the portion of the administered radioactivity excreted in bile. Therefore the present authors think that disappearance of radioactivity in perfusate of the isolated liver after administration of 3HDHE is a linear process following first-order kinetics.

Authors present the initial experience with the closed locked intramedullary fixation of long bones (mainly the tibial bone) in conditions of the Teaching Hospital. Possible improvisation is reported on when lacking the foreign osteosynthetical material.

Various doses of carbon tetrachloride (0.625 mmol to 10 mmol CCl4/kg body weight) were administered to female Wistar rats. Liver damage after a single treatment was evaluated by serum aminotransferase levels and by the extent of necrotic areas in parenchyma. Liver regeneration was evaluated by 3H-thymidine incorporation into liver DNA and by the number of dividing hepatocytes. Mitotic index of hepatocytes rose in parallel with the specific activity of DNA and with the extent of necrosis. However, the activities of serum aminotransferase AST and ALT increased much more rapidly and did not correlate either with necrosis or with regeneration rate. Increased membrane permeability in morphologically intact cells, increased synthesis of the enzymes by the liver as well as the leakage from necrotic cells are discussed as possible causes of the high aminotransferase activities in serum.

In the retrospective study the author shows the survey of 4,468 gastro and colonofiberscopies performed at the Endoscopic Unit of the Clinic of Surgery in Hradec Králové during the time span 1981-1990. Indications and contraindications, as well as the conditions for performing these endoscopies are being considered. Experiences with the optimum preparation of such patients are also described. Furthermore, the question of the occurrence and importance of gastrointestinal polyps is being discussed. In the second part of this study mainly the problematics of the endoscopical polypectomy is revealed. This set includes 612 patients with polyps in both the upper and lower parts of the gastrointestinal tract. The group of polyps has been divided and studied in greater detail from several points of view, such as their histological character, morphology, localization, clinical symptomatology and others. The endoscopic treatment of polyps is further compared with the alternative way of treatment. The survey of complications is also given. In the discussion and conclusion the follow-up policy, which differs from that of some other authors, is being supported and further ways of diagnosis in this field are outlined, too.

In the course of the study of the syndrome of severe limb ischemia (SLI) in a representative clinical material of 300 patients and a number of experimental studies, we arrived to the proposal of this optimal methodical procedure for acute vascular closures of traumatic and non-traumatic origin in the limbs: a) In every injury and sudden pain with a change of the function of the limb, it is necessary to think of the SLI syndrome and to search targetedly for it. b) In injuries connected with bleeding our first-rate task is the control of this bleeding. For a temporary arrest of the bleeding it is necessary to prefer more physiological methods sparing collateral circulation to the still most used tourniquet. For this purpose a new device for temporary hemostasis called Hemostop has proved itself, designed by the author and attested both experimentally and clinically, protected as a Czechoslovak patent. From surgical measures have acquitted themselves from this viewpoint the insertion of vascular clamp, ligature of the vessel or its temporary cannulation. c) To set the diagnosis of SLI, it usually suffices a careful anamnesis and clinical examination, advantageous is the investigation by ultrasound. The angiography because of time consumption should be used only in indicated cases. d) The time factor--"race against the time"--has to be always borne on our mind. It is necessary to achieve the recovery of blood circulation in the limb up to 6 or at the latest up to 10 hours from the onset of injury or closure. e) For shortening of the period of tissue hypoxia it is of advantage to use the temporary cannulation of injured vessels. This should be used always, whenever because of any reasons, it is not possible to execute the final reconstructive operation up to 10 hours since the injury, e. g. in polytraumatism, transport difficulties and the like. f) In isolated vascular injuries without bleeding (about 45%) and in all non-traumatic SLI the patients must be efficiently heparinized (i. v. administration, at best by infusion) to prevent the growth of the distal thrombus. g) Final vascular reconstruction should be performed only by erudited surgeons, always with thromboctomy and in protected coagulum. Optimal reconstructive performance should be chosen: for embolism the thromboembolectomy, for acute thrombosis usually the bypassing the afflicted vascular portion by the graft, in injuries appears as the optimal reconstructive measure the anastomosis end to end. At the simultaneous or isolated lesion of the stem vein, we must always try to reconstruct it.(ABSTRACT TRUNCATED AT 400 WORDS)

The experiments were performed in the younger adult normotensive rats of Wistar strain and in the genetically hypertensive rats of Koletsky type. Motor activity was traced under regime 12 h light/12 h dark (light on at 6 A. M., light off at 6 P. M.). The activity was traced from 10 h A. M. during 24 hours by pneumoactograph described by Weggemenn. In the control genetically hypertensive males of Koletsky type phase advance was found when compared with the normotensive rats of Wistar strain. This phase advance in the former animals is missing under acute diazepam treatment (0.5 mg/kg). In control animals the novelty induced hyperactivity shows in the genetically hypertensive males of Koletsky type the lower rate of habituation than in the normotensive males of Wistar strain, i. e., the former animals show "sustained activity" in new environment. Novelty induced hyperactivity was alleviated in both strains of rats by the acute diazepam treatment; the effect of the latter drug was more expressive in the normotensive rats of Wistar strain.

The authors describe a flat stainless steel container with two necks of the volume 160-180 ml, manufactured according to their own design as well as their first experience with controlled-rate freezing of leukocytes and/or peripheral blood stem cells (PBSC) in this container. The containers meet the requirements of clinical application, i.e. they are made of non-toxic stainless steel, the inner and outer surfaces are polished electrochemically, sterilization by autoclaving is possible, several containers can be frozen simultaneously in a freezing chamber of a programmable freezer and storage of containers in both vapour and liquid phase of nitrogen is possible. Analysis of the cell volume distribution in suspensions of leukocytes and PBSC collected by hemapheresis showed high recovery of cells after thawing. The advantages and disadvantages of metal containers in comparison with disposable plastic bags are discussed in detail.