Acta medica Hungarica最新文献

The non-invasive differential diagnosis of ischaemic heart disease (IHD) and acute myocarditis or secondary cardiomyopathy following myocarditis can be difficult on the basis of the complaints, resting and exercise ECG and nuclear cardiological tests. 92 patients (mean age: 46 years) in the first step and 100 patients (mean age: 44 years) in the second step all with heart troubles, were examined. Besides determination of the routine parameters, nuclear haemodynamical and haemorheological measurements were carried out. Then each group of the patients was classified into 4 subgroups: 1) myocardial infarction /n:9/, 2) IHD /52/, 3) myocarditis /28/, 4) chronic cor pulmonale (CCP) /3/ subgroups in the first group and 1) normal /n:20/, 2) IHD /50/, 3) myocarditis /16/, 4) chronic cor pulmonale /14/ subgroups in the second group. The patients were reclassified by our multivariate pattern recognition algorithm (PRIMA). The average effectiveness of our method was over 80%, the recognition abilities for the subgroups (classes) ranged between 71 and 100%. An analysis of the discrimination power of the properties has made it evident that the haemorheological features were more characteristic than the haemodynamic ones in distinguishing the two differential-diagnostically critical groups. Our results show that our multivariate statistical method can be useful for the computer-aided decision in cardiological diagnostics.

Sinus tachycardia and atrial fibrillation are frequent features in hyperthyrosis while sinus node dysfunction is regarded as a rare complication. Bradycardia may cause diagnostic problems mainly in atypical hyperthyrosis of the old age. The authors analysed distribution and age related association of the rhythm disorders in hyperthyrosis. In case of the appearance of Sick Sinus Syndrome (SSS), parameters representing the function of sinus node were studied by electrophysiological investigations. Above the age of 50 years incidences of atrial fibrillation and SSS were significantly increased. The abnormal sinus node function proved to be reversible in a portion of the cases. In old age, in case of occurrence of the symptoms of SSS, possibility of hyperthyrosis also should be considered, especially when indication of permanent pacemaker is established.

Serum alpha 2HS-glycoprotein (A2HSG) concentrations of 63 patients with systemic lupus erythematosus (SLE) were determined, and found to be significantly low compared to those of 59 healthy blood donors. The diminution of serum A2HSG concentration was proportional to the degree of activity of SLE, and was not influenced by secondary infections. There was a statistically significant positive correlation between serum A2HSG and the C3 complement component levels. A negative correlation between serum A2HSG and IgG, IgA concentration and anti-DNA activity was observed. Serum A2HSG was significantly low in cases of positive for the following laboratory parameters: anti-nuclear antibodies, circulating immune complexes and LE cell phenomenon. We found no correlation between serum IgM concentration, cryoglobulins, latex agglutination and serum A2HSG levels. The unusually good negative correlation between A2HSG pathogenetical role of this glycoprotein in SLE. The determination of A2HSG concentration may be of clinical importance in SLE.

The occurrence of serum interferon was studied in 39 patients with acute viral hepatitis B. Antiviral activity of interferon in serum was determined by measuring the inhibition of the CPE of vesicular stomatitis virus on bovine kidney cells (MDBK). Among these patients only 5 (12.8%) had detectable serum interferon level during the first week of hospitalization. The antiviral activity of the interferon-positive sera was low (5-10 IU/ml).

The effect of vasodilator drugs on limb circulation was investigated in 59 hypertensive patients. Forty-six of them suffered from obliterative arterial disease, too. The drugs administered were: hydralazine, nitroglycerine and sodium nitroprusside. Isotope dilution method was employed to assess limb blood flow before and after acute treatment. Limb vascular resistance was calculated from the limb blood flow and the mean blood pressure. A marked increase in limb blood flow and decrease in vascular resistance following vasodilator treatment were observed in hypertensive patients suffering from obliterative arterial disease. No difference was found between the various vasodilators investigated. Normotensive patients with arterial disease exhibited the same response to a lesser degree. In exceptional cases, where blood pressure dropped abruptly, limb blood flow decreased and limb vascular resistance increased. The data show that vasodilator therapy in hypertension results in diminished limb vascular resistance and improved limb circulation in patients with obliterative arterial disease.

Non-specific cell immunity and, within it, the change in K-cell activity, can be relevant in alcohol-induced diseases of the liver. It was examined for this reason how alcohol in its different concentrations influences the activity of K-cells under in vitro conditions. Furthermore, the cytotoxic capacity of K-cells was defined in 22 chronic alcoholics and 112 patients with alcohol induced hepatopathies. The latter were divided into subgroups. Cytotoxic capacity of lymphocytes in the peripheral blood was determined in a test against human red blood cells. 123 healthy volunteers made up the control group. A high concentration of alcohol was needed to impede K-cell capacity under in vitro conditions. It is supposed that the gradual growth in K-cell activity registered in cases of alcohol-induced hepatopathy may point--though only indirectly--to the development of an antibody-dependent cellular cytotoxic reaction.

Serum lysosomal cysteine proteinases cathepsin B, H, L and metalloproteinase (MMP7-ase) activities of 14 patients suffering from gastrointestinal and bronchial carcinomas were investigated. The serum cathepsin B and H activities were significantly diminished in the carcinoma group as compared to the controls, while the activity of cathepsin L and of MMP7-ase was normal.

Normal control somatosensory evoked potential data (elicited by stimulation of the posterior tibial nerve), of 20 healthy subjects were compared to the electrophysiological data of 20 patients with the diagnosis of definite or probable multiple sclerosis. The demyelinating process affects all segments of the response, causing increase in latency and decrease in amplitudes as well as lack of the potentials during the disease. Based on the literature, the neurological localization values of TPSEP are summarized. Due to its outstanding sensitivity in these cases, the procedure as advised by the authors should be used in demyelinating processes and in other spinal cord disease of different aetiology.

Water content in the liver in vivo was determined in 89 patients (33 with normal liver and 56 with chronic liver disease), simultaneously with ultrasonography and histopathological examination. A part of each biopsy specimen was used for this purpose. The difference between wet and dry weights was calculated from the pre- and post-lyophilization weights. According to the attenuation type of ultrasonic images, the patients were divided into two groups, viz., patients of low attenuation type (i.e. patients with type I bright liver) and those of high attenuation type (i.e. with type II bright liver). As to water content, no significant difference was observed between the two groups. No correlation was found between liver water content and histopathology either. It is concluded that knowledge of correlation between numerous parameters is needed to clarify the reason of attenuation differences.

Until recently the practitioners in Africa, and also those in the temperate climates, had to rely on literature written in an environment that is very different from the tropical circumstances. In the rapidly changing world the physician must be well-informed about the differences which exist between the medical practice of the tropical and of the temperate climates. In this article the characteristics of gastric and colorectal cancer in the tropical (sub-Saharan) part of Africa are briefly reviewed.