Acta medica Hungarica最新文献

Forty-eight preselected patients (pts) with arteriosclerosis obliterans were investigated by dipyridamole thallium scintigraphy (DTS). No correlation was found between the distribution of positive or negative exercise ECG testing (ExECG) and isotopic risk-scores (P > 0.1 in the chi-square test). We assessed cardiac ischaemia in 12 pts with insufficient ExECG. Although only 2 pts had documented previous myocardial infarction, 20 pts exhibited irreversible perfusion defect. Silent reversible or irreversible ischaemia was identified in 12 pts (25%). Seven pts would not have been diagnosed to have coronary artery disease (CAD) even by ExECG. In conclusion, DTS was found very useful in these cases. We support a stepwise cardiac risk stratification before major vascular surgery.

The distribution of blood group isoantigens (ABH) was studied with the specific red cell adherence test (SRCA); the red blood cells were visualized by the benzidine-peroxidase reaction. The H antigen was detected with Ulex europaeus agglutinin I lectin by direct immunoperoxidase technique. One hundred and seven bladder tumours were tested. It was found that blood group isoantigens diminished with immaturity (grade) and tumour invasiveness (T stadium). Patients with ABH blood group isoantigen deletion should be considered to be belong to a particularly high-risk group. The preservation of blood group antigens in grade II-III carcinomas may be useful in the choice of treatment (conservative or radical). In six cases in the area of squamous metaplasia of invasive carcinomas a strong false SRCA reaction was noticed detecting presumably the blood group determinants of the epidermal growth factor receptors.

The effect of JEG-3 choriocarcinoma supernatant on human natural killer cell and lymphokine-activated killer cell activity was investigated. Choriocarcinoma supernatants from JEG-3 cell lines were obtained at the time of their optimal growth. K562 erythroblastoid cells were used as target cells for natural killer and lymphokine-activated killer cell mediated lysis in a 51Cr release assay. The choriocarcinoma supernatants had a significant dose-dependent suppressive effect on natural killer and lymphokine-activated killer cell activity. This suppression was more expressed at high effector: target cell ratios. Therefore, choriocarcinoma supernatants appear to have potent inhibitory effects on many aspects of cellular immunity, although, additional studies should be performed to further characterize and identify immunoregulatory molecule(s) in choriocarcinoma supernatants.

The changes in gastric (antral and fundic) mucosal DNA and RNA contents were investigated in long-term (80 days) treatment of rats with orally administered prostacyclin. Prostacyclin caused a dose-dependent, significant increase of the DNA levels in both parts of the gastric mucosa together with a significant thickening of the fundic mucosa. The observed changes (decrease) of the RNA/DNA ratio in the fundic as well as antral mucosa, are interpreted as a sign of accelerated cell renewal, i.e. hyperplasia.

Twelve patients with Graves' ophthalmopathy (grade 1-6, ATA classification) were treated with Cyclosporin-A, systemically in combination with methylprednisolone. We observed slight or moderate favourable effect in 9 cases. Our data suggest that the benefit was due to the methylprednisolone, the effectivity of which was enhanced by the cyclosporin even in the glucocorticoid-resistant cases.

Functional insulin substitution, an insulin regimen made up of two daily injections of intermediate-acting insulin and prandial boluses of regular insulin, was to be introduced in 49 type 1 diabetic patients, as previous regimens consisting of two or three daily injections proved to be inefficient due to the patients lifestyle or inherent metabolic lability. Forty-five patients were treated with human insulin injected by NovoPen. In 38 cases therapy was changed in the frame of a one-week, small-group, inpatient, structured educational course. After a mean 14 months of follow-up metabolic status improved in 33 cases while there was further derangement in 16. Eighteen patients were practising true functional therapy, i.e. doing blood glucose tests before each injection. Further 22 diabetics were trying to achieve better metabolic control through 2-3 daily blood glucose tests and insulin dose corrections. The metabolic status was not affected by the frequency of blood glucose testing, rather by raising of the daily dose of short acting insulin in conjunction with the switch in therapy acting beneficially. All patients insisted on using NovoPen further on.

Patients kept on haemodialysis because of chronic renal insufficiency were investigated for lipid profiles. The cholesterol level did not differ as compared to the age-matched control, while the triglyceride level was elevated. The correlation was found between the lipid parameters, period spent in dialysis programme and level of serum creatinine and urea. In renal failures of different origin the lipid levels are in relationship with the underlying disorders.

The author found, among 329 twin pairs, 50 (15.2%) cases of weight discordancy reaching or exceeding 22%. Among the 50 twin pairs, there were 65 boys and 35 girls, a sex ratio of 185.7. This degree of weight discordancy appears to be unrelated to maternal age, parity and gestational length. Growth retardation of one or both fetuses was significantly more frequent (80%) among weight-discordant than among concordant one (11.1%). There were more perinatal deaths between discordant than concordant twins. Among the twins who were born with evidence of growth discordancy, there was slightly increased incidence of abnormal presentation, delivery by cesarean section, and low Apgar score as compared to the concordants.

The case history of a 30-year-old female patient is reported. Following an unknown viral infection that had occurred four years earlier, insulin-dependent diabetes mellitus vitiligo, Addison's disease, amenorrhoea, hyperthyreosis and, finally, severe pancytopenia with dominant thrombocytopenia developed. On the basis of clinical aspects and laboratory findings, an infrequent polyglandular autoimmune syndrome (type II) was verified. Substituent therapy and steroid stoss therapy also was introduced, without any sign of improvement. For the lack of therapeutic effect and owing to serious thrombocytopenic bleeding, treatment with Cyclosporin-A was indicated, which produced total remission of the illness. Nowadays the patient being on follow-up, has no sign of disease activity.

Circadian profiles of the serum levels of cortisol and five androgens were studied in 20 females including 8 controls, 7 patients with ACTH-dependent Cushing's syndrome and 5 with hypercortisolism due to adrenal adenoma. A significant 24-h periodicity was found for each steroid in all groups. Besides hypercortisolaemia, a significant increase of 11-hydroxyandrostenedione was shown in both forms of Cushing's syndrome. The most conspicuous finding was a decreased dehydroepiandrosterone and its sulphate in adrenal adenoma. The peaks for the studied steroids were shifted from the morning hours towards the noon in ACTH-dependent Cushing's syndrome and towards the evening (for cortisol) and night hours (for androgens) in adrenal adenoma.