Acta medica Hungarica最新文献

Normal reference values of lysosomal enzyme activities (alpha-glucosidase, mannosidase, fucosidase and arylsulfatase-A) were determined in chorionic villi obtained from artificial abortion in the first trimester of normal pregnancies (gestational weeks 6 to 11). Villi were homogenized comparatively either in saline or in Triton X-100 detergent. The alpha-glucosidase, mannosidase and arylsulfatase-A enzyme activities significantly diminished if homogenization was done in saline instead of Triton-X while the difference in fucosidase activity was not significant. Significant correlation was detected between alpha-glucosidase activity and week of gestation. It is suggested that Triton X-100-homogenization should be used for the lysosomal enzyme determinations in chorionic villi because the solubilization of enzymes from the lysosomes is complete in this case than with homogenization in saline.

A retrospective study was performed on 1040 diabetic patients. The survival time of those treated with first generation sulphonylureas (n = 227) was considerably (P < 0.001) shorter after the first attack of angina pectoris (5 +/- 1 years, mean +/- S.E.) or acute myocardial infarction (6 +/- 1 years) than of those (9 +/- 1 years) on glibenclamide treatment (n = 144), with regime alone (n = 282) or treated with insulin (n = 387). The systolic blood pressure of patients with first generation sulphonylureas (166 +/- 1/91 +/- 1 mmHg) proved to be higher (P < 0.01) than those treated with glibenclamide (159 +/- 1/91 +/- 1 mmHg) or being on regime alone (155 +/- 1/89 +/- 1 mmHg) or on insulin (156 +/- 1/89 +/- 1 mmHg) treatments. Serum sodium level was found to be lower (P < 0.05) in patients treated with any kind of sulphonylureas (138 +/- 1 mmol/l) than in the other patients (143 +/- 1 mmol/l). During an observation period, 576 of patients died, 412 of them due to cardiovascular or renal failures. Among the diabetic subjects suffering from coronary heart disease no difference could be detected in risk factors except for higher systolic blood pressure. The shorter survival time of patients treated with first-generation sulphonylureas might be explained by the arrhythmogenic activity of first-generation sulphonylureas. Improvement in therapy, metabolic and cardiovascular alterations during the survey can not be responsible for the shorter survival time of patients treated with first generation-sulphonylureas.

Unlabelled: The study was aimed at investigating the effect of atrial dilatation on the genesis of supraventricular tachyarrhythmias following myocardial reperfusion. Experiments were carried out in 26 mongrel dogs under pentobarbital narcosis with artificial ventilation. Electrophysiological study was performed for studying the arrhythmic condition of the heart. Investigations were carried out: (i) in normal condition, (ii) during atrial stretching (balloon dilatation of the left atrium), (iii) in reperfusion following myocardial ischemia, (iv) in reperfusion combined with atrial stretching. On reperfusion the irritability of the atrium increased moderately (on atrial extrastimuli in 3 dogs non-sustained atrial tachycardia, in 7 dogs repeated atrial responses could be induced). Reperfusion with atrial stretching, however, very markedly enhanced the atrial vulnerability, and in 19 dogs atrial tachycardia appeared spontaneously. Comparison of the effect of atrial stretching to that of atrial stretching + reperfusion showed that the reperfusion significantly augmented the arrhythmia-inducing effect of atrial stretching.

Clinical investigations: Aortocoronary bypass operations were followed by development of supraventricular tachycardia in 41 out of 428 operated cases. Atrial dilatation was detected in 37 cases, mostly before the appearance of atrial tachycardia. The data seem to prove that atrial dilatation has an important part in the pathogenesis of supraventricular tachyarrhythmias following reperfusion of myocardial ischemia.

The serum antihistone antibody (AHA) positivity of patients with various autoimmune diseases was compared with their positive reaction for antinuclear factor, rheumatoid factor, lupus erythematosus factor, cryoglobulin, immunocomplex, C-reactive protein, total protein, gamma globulin, IgG and IgM. In non-drug-induced SLE cases the predictive value of the AHA test was not higher than that of the other tests. It was striking that in 42% of patients with non-autoimmune disease aged over 70 the AHA test was positive. Elevated IgM values were recorded in about 70% of positive AHA samples.

Atherogenic (lipid-rich) diet suppressed mitogen-induced lymphocyte blastogenic responses in rats. Supplementation with vitamin E completely abolished the suppressive effect of the diet. The atherogenic diet also decreased the tumour necrosis factor alpha (TNF-alpha) activity produced by spleen macrophages, however, vitamin E supplementation failed to abolish this effect. Diet or supplementation had no measurable action on interleukin-1 (IL-1) production of macrophages.

Unlabelled: In previous studies the incidence of acute mountain sickness (AMS) at medium altitude was examined in the Austrian Alps, where many tourists come from low parts of Europe. This study assesses the influence of the height of home residence on the incidence of AMS at medium altitude. The severity of high-altitude adaptation disorder was quantified by using a scoring system after an interview and a clinical examination in 84 lowlanders, mainly those from Hungary. Forty-two alpinists with a home residence of 800 to 1000 m served as control. The incidence of AMS was 1.4% at 2000 m and 7.4% in 3000 m. The most frequent symptoms were slight headache and peripheral or periorbital oedema. The AMS-score of the Hungarian alpinists did not differ significantly from that of the alpinists with a home residence of height 800 to 1000 m.

Conclusion: in contrast to the situation at high altitude, at medium height tourists from lowlands are not at higher risk of AMS than other alpinists.

Haemoglobin (Hb), free erythrocyte porphyrins (FEPs), protoporphyrin and haem contents as well as delta-aminolevulinic acid (ALA)-dehydrase activity were estimated in blood samples from patients with chronic renal failure (CRF), from those with renal transplantation, and from healthy control subjects. In CRF patients a highly elevated FEPs level and a significantly increased protoporphyrin concentration were found. A well-defined decrease was observed in the mean value of ALA-dehydrase activity, Hb and haem contents when compared to the control values. However, in patients with renal transplantation significant decreases were observed in Hb and haem concentrations while the ALA-dehydrase activity and the FEPs and protoporphyrin concentrations were approximately at the control levels.

A one-year study was conducted to evaluate the clinical significance of anticardiolipin antibody (ACA) whether it was a reliable predictor for thromboembolic events and related diseases in systemic lupus erythematosus (SLE) patients. The correlation between ACA and anti-ds-DNA antibodies and disease activity was also studied. Of particular importance was the question if any association could be found between ACA positivity and renal disorders in SLE patients. One hundred and eighty-seven serum samples from 88 SLE patients were assayed for ACA. Clinical records of these patients were reviewed for a history of thromboembolic events, related diseases and renal disorders, 80.7% of the 88 SLE patients were positive for ACA. The incidence of thrombosis and related diseases within this group was 35.1%. Since the correlation was not significant, it does not seem to be advisable to use elevated ACA values as predictive for thromboembolic events and related diseases. On the other hand, an apparent association between ACA levels, anti-DNA antibody levels and disease activity was found.

Interrelationships between quantitative assessment of portal (%Qp) and arterial (%Qa) components of hepatic blood supply obtained by dynamic hepatoscintigraphy, and clinical variables characterizing the severity of liver cirrhosis and portal hypertension were studied in 25 cirrhotic patients. The variables, clinical state, size of oesophageal varices, ascites accumulation, sonographic stigmata of portal hypertension, liver mass and elimination rate of lidocaine and antipyrine were studied. The %Qa rose in proportion to the severity of liver injury estimated from the Child-Turcotte and McCormick grading scores. The mean %Qa for patients with Child A cirrhosis was significantly higher than that for 8 healthy subjects (34.8 +/- 7.9% vs 18.1 +/- 4.0; P < 0.01). The %Qp values showed relationship with the size of esophageal varices, provided discriminatory data with respect to the ascitic fluid accumulation and the development of intraabdominal collateral circulation. The liver mass had no impact on hepatic dual blood supply pattern, but was linked with the rate of antipyrine clearance. Neither antipyrine clearance nor lidocaine elimination rate corresponded to alterations of hepatic dual blood supply. The %Qp showed a negative correlation with the initial half-life of lidocaine, which was referred to lowered hepatic uptake of the drug. It is concluded that the quantitative assessment of %Qp and %Qa reflect the advancement of portal hypertension better than liver function failure does.

The theme of maternal mortality and morbidity is of transcending macroethical importance. High rates of maternal mortality and morbidity can be significantly reduced by cost-effective means that are not dependent on advanced biotechnology. It has been shown that a major cause of maternal mortality comes from women (i) bearing children too early or too late in their reproductive lives, (ii) too frequently or at insufficiently spaced intervals. If women were able to control their fertility in order not to have children at unwanted times in periods of their life when pregnancy is inimical to their health, the incidence of maternal mortality and morbidity would drop. Improved standards of women's education, both in general and in particular regarding women's reproductive health, would reinforce the understanding of how to protect and improve one's reproductive health, and would accelerate the decline of maternal mortality and chronic morbidities. Accordingly, the macroethical demands of respect for autonomy, beneficence and justice would coincide. The value of justice would be served not only regarding women themselves, particularly those who have traditionally been vulnerable by virtue of their growing age, or dependent status in their communities, but also regarding the children dependent on such women, and families also dependent on the services of such women, like mothers, wives, daughters and grand-daughters.