Acta medica Academiae Scientiarum Hungaricae最新文献

The individual enzyme inducibility was studied with methods of menthol loading and sulphobromophthalein in groups of patients with low and average metabolism. Both methods are suitable for testing inducible conjugation systems by providing indirect information on the rate of drug elimination. In the low-metabolism groups the response in per cent correlated inversely with the initial value, and the changes were significant not only in the low but also in the average-metabolism group at the end of 30 days of phenobarbital treatment. The results are discussed with regard to the avoidability of undesired drug effects.

Besides its antilipidaemic effect, the new clofibric acid derivative (N-bis-(p-chlorohenoxy)-acetyl-urea) has an enzyme-inductive effect. The drug was administered (100 mg/kg orally) to male, Wistar rats for three days. The treatment raised the weight of the liver, the content of liver microsomal protein and cytochrome p-450 and shortened the hexobarbital sleeping time. The increase of cytochrome p-450 dependent biotransformation was found by in vitro methods in 9000-g supernatant of liver homogenate. There was a growth in biotransformation of substrates of type I (ethylmorphine, aminopyrine) and an extreme increase in reduction of nitrobenzene. We did not find any change in biotransformation of the type-II substrate aniline. In 16 patients suffering from Gilbert's syndrome, there was a decrease in the level of serum bilirubin, and increase of D-glucuric-acid output in urine and bromsulphophthalein transport maximum following the treatment of this drug given in 150 mg/day orally for three weeks. After this treatment, the level of gamma-glutamyl-transpeptides did not change. The authors highly recommend the serious consideration of metabolic interaction during the clinical application.

Blood loss was measured by total-body counting in conformity with the fall in activity, the calculated or predicted blood volumes being known. On the ground of the predicted and calculated blood volumes it was the Nadler formula which gave the best approximation. The method was employed for the measurement of blood loss in users of intrauterine contraceptive spirals. It was found suitable for the measurement of a sudden blood loss of major intensity.

The new intracardiac electrophysiological method: His bundle electrocardiography, combined with the electrophysiological examination used in routine clinical practice, has considerably improved our knowledge of the cardiac dysrhythmias. It helps to localize the focus of the atypical junctional and other supraventricular premature beats complicated with either organic or functional intraventricular conduction disturbance. The various forms of paroxysmal tachycardias can be differentiated more exactly from each other. In pre-excitation syndrome, it has become possible to detect the abnormal pathway and to screen the patients susceptible to life-threatening arrhythmias. By means of this the diagnosis of sick sinus syndrome and estimation of its severity can be made more exactly. In addition to the diagnosis, the electrophysiological examinations connected with pharmacological tests give valuable information whether medical or pacemaker therapy should be applied. Six cases of various forms of cardiac dysrhythmias are presented to demonstrate the superiority of this method.

The albumin and the IgG were determined in cerebrospinal fluid (CSF) and serum samples from 312 patients by radial immunodiffusion. The correlation between the CSF/serum ratio of IgG and the CSF/serum ratio of albumin was determined by regression analysis in three groups of patients with no signs of IgG synthesis within the central nervous system. The patients were selected on the basis of the state of the blood-CSF barrier, as indicated by the ratio of serum/CSF of albumin. Using the +2 S.D. regression borderlines, the maximal amount of IgG derived from the blood and the minimal amount of IgG synthesized within the central nervous system can be calculated in CSF samples of patients with acute infections and chronic inflammatory diseases.

The role and pharmacological regulation of the ATP-adenylate-cyclase--cAMP system were studied in the mucosa of the gastric fundus, and in the forestomach, of pylorus-ligated rats to elucidate the development of gastric hypersecretion and ulceration. (1) cAMP content of the tissue of the fundus mucosa and of the forestomach decreased before the significant increase of gastric H+ output and ulcer development; (2) the gastric H+ outputs depended on the breakdown of ATP in the fundus mucosa; (3) the gastric H+ secretion was inhibited in a dose-dependent way by theophylline, epinephrine and cimetidine; (4) the inhibition of gastric H+ secretion by epinephrine , theophylline or epinephrine plus theophylline associated with a significant increase in the mucosal cAMP of the gastric fundus (5) the significant increase in gastric H+ secretion due to histamine associated with a significant decrease in fundic mucosal cAMP; (6) the gastric H+ secretion could be inhibited dose-dependently by ADP, AMP, cyclic 2', 3'-AMP and cAMP; (7) the inhibition of gastric H+ secretion by cimetidine developed without and with histamine application in pylorus-ligated rats; (8) the histamine on gastric H+ secretion could not be stimulated further with theophylline (9) no significant correlation was found between the mucosal cAMP level and the gastric H+ secretion and/or between the decrease of mucosal cAMP content and gastric H+ secretion. It has been concluded that in pylorus-ligated rats (1) the gastric H+ secretion is an ATP-dependent process; (2) the cAMP system has an inhibitory effect as regards the development of gastric hypersecretion and of ulceration; (3) histamine and cimetidine show no close correlation with the cAMP system; (4) an extracellular and intracellular feed-back mechanism system exists between th ATP-membrane-bound ATPase-ADP and the ATP--adenylate cyclase--cAMP systems in the background of the development of gastric hypersecretion and ulceration.

Fifty patients with arterial hypertension of various causes were treated with a combination consisting of Nepresol, a beta-adrenergic receptor-blocking agent and a diuretic. Duration of treatment ranged between 3 months and 5 years. A significant reduction of blood pressure was attained in all of the cases, with a return of the values to the normal range in a high proportion of the patients. The renal function did not deteriorate during therapy, but owing to potassium loss regular potassium replacement was required in the majority of the cases. Allergic reactions appeared in two cases. Neither SLE nor rheumatoid arthritis was encountered. Positive ANF reaction and a significant elevation of the Rose-Waaler titre were demonstrated in a number of cases. The benefits as well as the hazards of the therapeutic use of hydrazine derivatives are pointed out.

Among patients with ITP, a group of 9 subjects displayed a reduced platelet turnover. In their bone marrow the megakaryocyte mass was measured by 59Fe, and the results were referred to those of 6 patients with a moderately increased and of 6 with a considerably increased platelet turnover. In the low-turnover group the megakaryocyte nuclear lobe number was subnormal cells with basophil cytoplasm were in the majority and the number of megakaryocytes was increased, whereas in the other two groups of megakaryocite population showed a shift to the right, and increased nuclear lobe number, and the number of megakaryocytes, related to the erythroid cells, was increased. It is therefore assumed that in the case of a reduced platelet turnover, the megakaryocytes are damaged, primarily their maturation in the bone marrow. The three groups showed, however, no clinical differences.