Acta medica Iugoslavica最新文献

In 32 patients with dilated cardiomyopathy the percentages of helper (CD4+) and suppressor (CD8+) T lymphocytes, as well as their ratio, have been analyzed. The percentage of CD8+ lymphocytes in the group with dilated cardiomyopathy was 20.62 +/- 8.27% (X +/- SD), vs. 26.38 +/- 6.19% in control group; the difference was not statistically significant. The percentages of CD4+ lymphocytes were similar in both groups, 39.55 +/- 12.86% vs. 40.52 +/- 6.59%. The CD4+/CD8+ ratio was markedly higher in the group with dilated cardiomyopathy, 2.49 +/- 2.10 vs. 1.65 +/- 0.49, but the difference was not statistically significant, probably because of great variability in the group. In the subgroup of 12 patients with possible alcoholic etiology of dilated cardiomyopathy, the values were almost identical to those of the remaining 20 patients. No correlation between echocardiographic fractional shortening of the left ventricle and any of the aforementioned values of T lymphocytes in the group of patients with dilated cardiomyopathy was found. The tendency toward decline in number of suppressor T lymphocytes is in accordance with the hypothesis that the "overreacting" inflammatory response to (viral) myocarditis might be the cause of dilated cardiomyopathy. However, the specificity of the decline of suppressor activity in respect to the other causes of heart failure is questionable and the analysis of its significance is complex. This is due to dynamic character of immune disorders, and a considerable number of other theories considering the etiology and pathogenesis of the disease also exist. The need to perform complex studies is anticipated, including continual observation of clinical, immunologic and bioptic parameters of the disease.

The authors present the frequency of urinary tract infections in hospitalised infants. A retrospective study of infants hospitalized during a five year period, from 1979-1983 was made. The average frequency for the mentioned period was 12%, all of which were bacterial infections. In 70.7% of patients we diagnosed cytopyelonephritis. Girls prevailed among the patients with urinary tract infections, even in the neonatal period. Vesicoureteric reflux was confirmed in 36.5% children. The results of this study show that the symptoms of urinary tract infections in infancy are not specific. As the frequency of cytopyelonephritis and vesicoureteric reflux was high it emphasizes the significance of early diagnosis. In every febrile child, diagnosis of urinary tract infections should be suspected.

The study deals with the investigation results of psychodynamic factors relevant to the explanation of criminal behaviour. The research has been carried out on a sample of ten subjects sent to forensic psychiatric examination through court order, in order to evaluate their accountability and to suggest possible treatment. The sample included the diagnostic category of personality disorders only. Persons with psychotic disturbances, alcohol and drug addicts, mentally retarded and delinquents with organic-cerebral damage were not taken into consideration. The method of studying individual cases by means of psychodynamically oriented analysis of the subjects' development and other available data have been applied. The obtained results suggest that socialization defects, located in pregenital development phase are basis for criminal behaviour. The defects are due to badly disturbed object relations mainly in the oral and anal phase of development. In the subjects, narcissistic personality disorders can be diagnosed, while neurotic symptoms are present in a smaller degree. Criminal behaviour of these people can best be understood in the context of the theoretical concept of early narcissistic configurations actualization: grandiose self and idealized image of parental figures. In such cases the release of aggressiveness has been provoked, as a rule, by immediate endangerment of the self and by uncertain sexual identity. Unconscious feeling of guilt and need for selfpunishment appears often as criminal action driving forces. In all the subjects, structural disturbances in ego and superego formation were diagnosed. Greater integration of psychoanalytic knowledge into the theory and praxis of forensic psychiatry imposes itself as an indispensable basis for the reforms which are already under way and which are excepted in the future development of forensic psychiatry.

Six young female patients suffering from recurrent uveitis, all of them HLA B-5 positive, were followed-up 2-7 years (mean 4.5 years). Anterior hypopyon uveitis was present in two patients, retinal vasculitis in all, exudative recurrent retinal detachment in two, resulting in phthysis in one patient. Complete clinical work-up as well as serology were within normal limits. The effect of the corticosteroid therapy applied in all patients was dubious, while Cyclosporine gave only temporary relief in one patient. Promising vitreoretinal surgery was suggested to one patient.

This prospective study was carried out on 33 patients with clinically, serologically and ultrasonographically confirmed amoebic liver abscess. All patients were randomly treated with metronidazole and chlorochin or a combination of medicamentous therapy and percutaneous drainage. Ultrasonographic characteristics of amoebic liver abscesses were rotound or oval shape, usually hypoechogenic content with specific dorsal sonic enhancement, and in the majority of cases, location near liver capsule. Shorter duration of amoebic liver abscess resolution time in the group of patients treated with the combined therapy was observed particularly in the first four weeks of the treatment. The authors concluded that percutaneous drainage in combination with medicamentous therapy represents a successful therapeutic approach in the treatment of amoebic liver abscesses.

The effect of intranasally administered (DesGly9-Arg8) vasopressin (DGAVP) on certain aspects of cognitive functions of alcoholic patients was studied. The investigation was carried out in 103 chronic alcoholic patients. None of the patients suffered from Korsakoff's syndrome, portal encephalopathy or brain damage of other etiology. The trial was double-blind, placebo controlled. Psychological testing, which included certain aspects of attention, short-term and long-term memory and spatial orientation, was carried out on the day before (baseline measurements), on the last day (II), and seven days after the last administration of DGAVP (III). No treatment effect of DGAVP was observed. The results show that investigations with humans are infinitely more complex than those with animals, since a number of physiological and socio-psychological factors must be controlled. In this study of alcoholics two such factors: 1) duration of abstinence and 2) adaptation to test situation were identified.

A combination of 2 or 3 tumor markers was determined in the serum of 478 patients with malignant tumors. In 195 out of 213 patients with differentiated thyroid cancer and without relapse or metastases, the Tg concentration has undetectable. In 9 patients with nonfunctioning thyroid metastases the Tg level was correlated with the progress of the disease or the success of the treatment. In 114 patients with gastrointestinal cancer CA 19-9, TPA and IAP were measured simultaneously. The highest discrepancies between patients with relapse or metastases (increased values in 1/2 of patients) and patients without relapse or metastases (increased values in 1/4 of patients) were given by CA 19-9. In the serum of 90 patients with breast cancer increased CA 15-3 values were found in 2/3 of patients with relapse or metastases and in 1/4 of patients without signs of tumor. A combination of universal tumor markers TPA and IAP had no value in monitoring 26 patients with melanoma.

Histological studies describe in detail the changes of the small arteries wall with controversial results concerning lumen narrowing during the aging process. In this study, the anatomic and the angiographic parameters of the medial and lateral lenticulostriate arteries were analysed in 64 carotid angiograms. Only 20% of the total number of lenticulostriate arteries were shown on angiograms. Collateral branches were rarely visible, especially those of medial group. The course of the lenticulostriate arteries was mostly straight or moderately tortuous. No significant differences were noted in any of the measured parameters when compared with the age (p greater than 0.05). It appears that age-related changes spread over external layers of small arteries, with no lumen narrowing or filling defect.