Acta medica Hungarica最新文献

The renal and cardiac tissues of dogs were examined with autoradiographic method in ischaemic reperfusion trials with the aim of studying the access of exogenous superoxide dismutase (SOD) enzyme to the cells. Penetration of SOD into the cells was demonstrated. The enzyme showed special affinity to the mitochondira and myofilaments in the myocardium and it was seen both in the glomeruli and the tubules in the kidney. In both organs the uptake of the enzyme was most abundant in the ischaemic regions than in tissues with intact circulation.

Sixteen middle-aged, normotensive, slightly overweight male patients with previous myocardial infarction were studied during Holter-checked silent myocardial ischaemia. As reference, stress and late 201-T1 scintigraphy served for comparison with Cardiolite-MIBI silent ischaemic perfusion scan, both carried out in planar mode. The circumferential profiles differed in 9 cases, on region of interest basis the segment number difference was 10, but the late distribution segment number was near to both ischaemic numbers. The quantitative scores were distinctive (ratio 133-128/103) indicating the silent ischaemia appeared in the peri-infarct area. The silent ischaemic MIBI and stress 201-T1 ischaemic score difference was reduced by means of repeated SPECT investigation. With gated radionuclide ventriculography there was -4.3% difference between the left ventricular ejection fractions, measured with first pass MIBI technique during silent ischaemia and afterwards in basal state. The impairment of the left ventricular function was reflected on the stroke pattern of our Holter-based radiocyclogram, as well. Taking the 43.7-48.0 = -4.3% "ischaemic shift" into consideration it was a close correlation (r = 0.90) between the two kinds of ejection fraction determination. The major rhythm failures (occurring during the 24 h Holter monitoring) decreased to a higher degree the left ventricular ejection fraction than silent ischaemia or silent ischaemia and minor rhythm failure together (38-42-50%).

Warm ischaemia was provoked by occlusion of the left renal artery in dogs narcotized with Nembutal and it was studied whether a small (0.5 mg/kg body weight /n = 6/) or a large dose (5 mg/kg body weight /n = 7/) of superoxide dismutase (SOD) improves renal function during 90 min reperfusion, compared to the control group (n = 6). In the first period after release of occlusion (min 0-15) the GFR and cPAH values reached 10-20% of those in the contra lateral kidney with normal circulation. The GFR and cPAH values as well as urine flow, sodium and potassium excretion were not different in the three groups. Renal function significantly improved in all groups during reperfusion. At the early stage of reperfusion the malondialdehyde (MDA) concentration exceeded that before occlusion. Such an increase could not be seen when superoxide dismutase (SOD) treatment was applied. Our results show that SOD treatment does not improve renal function at the early stage of acuterly stage of acute renal failure of ischaemic origin.

A simple method based on rocket and crossed immunoelectrophoresis was adapted for detection of alpha 1 AT-HNE complexes in BALF: Agarose gel with anti-alpha 1 AT combined with intermediate gel containing anti-HNE was used for detection and evaluation of the ratio of complexes with HNE to the free form of alpha 1 AT. BALF samples from 31 patients divided into 5 groups suffering from various respiratory tract diseases were tested. It was found that 3 out of 8 patients with inflammatory pulmonary diseases showed the presence of both forms of alpha 1 AT, 7 out of 13 patients suffering from cancer showed both forms, whereas the complexed form was not detected in any of 8 patients with asthma bronchiale. It is suggested that the presence of alpha 1 AT-HNE complex may reflect, to some extent, the proteolytic status of pulmonary tissue.

The authors have reviewed the sex ratio in 353 offspring of adolescent parturients based on a 5-year material of their department. The 174 males and 179 females provided a sex ratio of 97.2; less than the usual ratio of 106. Interestingly, females are prevalent not only among low-birth-weight but also among average-birth-weight babies of adolescents. The hypothesis is presented that the anatomy of the cervix and the chemical composition of the cervical mucus may affect the sex ratio in some manner.

In order to examine the prognostic value of different cardiopulmonary variables in adult respiratory distress syndrome the data of 30 patients with this illness were studied retrospectively. The patients were divided into 3 groups: Group A: survivors (9 cases, 40 examinations), Group B: early stage nonsurvivors (8 cases, 37 examinations), Group C: late stage nonsurvivors (19 cases, 89 examinations). In 6 nonsurvivor patients a few measurements were done in the early and late stage, too. There were highly significant differences between Groups A and C (mean pulmonary arterial pressure, pulmonary arterial diastolic pressure minus pulmonary capillary wedge pressure, left ventricular stroke work index, systemic and pulmonary vascular resistance, inspired oxygen fraction, arterial oxygen tension per inspired oxygen fraction, mixed venous oxygen saturation, pulmonary shunt fraction, and oxygen delivery, but the differences in relation to other groups were less prominent. Using a step-wise discriminant analysis, it was found that the oxygenation parameters alone determined the outcome correctly in 68-75%. Extending the analysis to haemodynamic variables the result improved (72-80%). Similar prediction was obtained when parameters potentionally measurable by noninvasive methods were analysed (69-80%). These results suggest that it is possible to predict the outcome of ARDS correctly without any invasive monitoring technique.

Primary cancer of the parenchymal cells of the liver--hepatocellular carcinoma--is much more common in Africa (and Southeast Asia) than in Europe and North America. The very high incidence of this tumour is one of the outstanding problems of medicine in tropical countries. There is no doubt that it was already widespread in Africa before urbanization and industrialization. In this article the characteristics of hepatocellular cancer in the tropical (sub-Saharan) part of Africa are briefly reviewed.

The effects of daily 0.5 g vitamin C on plasma urea nitrogen, uric acid, cholesterol and triglyceride levels were recorded over a period of one month. There was a significant reduction in plasma cholesterol level (P less than 0.05). There was no significant effect of vitamin C on plasma urea nitrogen, uric acid and triglyceride levels (P greater than 0.05). It was a placebo-controlled trial. The research and control groups were formed of 105 and 47 volunteer university students, respectively. In these groups the mean ages were 20 +/- 0.33 (mean +/- S.E.M.) and 20 +/- 0.49 years, respectively. Mean body mass indices were 22.2 +/- 0.13 and 22.3 +/- 0.19 kg/m2, respectively.

Plasma fibronectin, serum procollagen-III-peptide and sex-hormone-binding globulin as non-specific markers of thyroid hormone effect at peripheral tissue level were determined and their values were related with serum levels of TSH, free-thyroxine and triiodothyronine during levothyroxine sodium replacement therapy for hypothyroidism. Low levels of biologic markers characteristic of hypothyroidism were normalized in consequence of hormone replacement and a negative correlation between their serum levels, and TSH concentration was demonstrated in most subjects. However, in some patients a discrepancy in the response to levothyroxine between the pituitary and other target organs was revealed. Additional evidence was disclosed that the pituitary thyrotroph sensitizes a minor decrease in serum thyroxine level, which would not be recognized by other target organs. Furthermore, it was revealed that during L-T4 replacement therapy in a large fraction of patients with subnormal serum TSH concentration blood levels of the measured markers often exceeded the upper limit of the normal range indicating a possibility of "tissue" thyrotoxicosis, besides the pituitary, in other target organs, too. According to the present study, which takes into consideration markers reflecting end-organ responsiveness to thyroid hormones, it is recommended to adjust the dose of levothyroxine to maintain serum TSH in the normal range. For patients with subnormal TSH concentration a close follow-up is obligatory and in case of concomitantly raised free-thyroxine level the reduction of the levothyroxine dosage is proposed.

It seems that in human gastroduodenal mucosal biopsy specimens from healthy persons there is a definite tendency toward a higher endogenous prostacyclin content in favour of women. This discrepancy is present in peptic ulcer disease, too. Smoking exerts an unfavourable effect on the gastric and duodenal mucosa. The target of this action is (among others) the endogenous prostacyclin content. In ventricular as well as duodenal ulceration there is a tendency toward decreased endogenous prostacyclin activity but (moderate) smoking,--as a continuous stimulus--seems to be capable of evoking higher endogenous prostacyclin levels. This phenomenon, most probably, constitutes a part of the reparative reactions against the noxa, i.e. smoking, itself. The results draw attention once again to a possible role of smoking in the development and healing of peptic ulcer disease.