Czechoslovak medicine最新文献

The authors pay complex attention to the research of the gnathic system, focused first of all to the mechanical interactions towards solid formations of the gnathic system. The results of their analysis show, that in the first cell already differentation to tensile functions of the membrane and compressive functions of its contents (cytoplasm) exists. In the osseous tissue the mechanical strain is also distributed to different substances, reacting differently to the mechanical stress according to their aggregate state--the liquid state secures an equal distribution of the developing compression, the collagens intercept and cushion the arising traction, and the mineral component the oriented compressions. Therefore, the bone tissue markedly differs from the inorganic homogenous solid substances, where the distribution of the mechanical strain is different. A detailed analysis shows that the form and structure of the bones is in accord with the course of the developing compressive strain and dependent on the mechanical consistency of the consumed food.

Five women aged 50-64 years with chronic renal failure caused by interstitial nephritis, maintained by chronic haemodialysis, were treated for three months with human recombinant erythropoietin. The blood haemoglobin level roce from 78.0 +/- 6.9 g/l to 108.4 +/- 15.5 g/l, haematocrit from 21.8 +/- 1.8% to 33.6 +/- 4.8%, and the rate of reticulocytes 1.8% to 4.9%. Serum ferritin concentration declined from 2213 +/- 1982 micrograms/l to 850 +/- 953 micrograms/l. Unlike the pre-treatment period, no blood transfusion had to be given during the administration of erythropoietin. The patients' general condition improved. There were no serious complications. The action of erythropoietin persisted for two months. Human recombinant erythropoietin is a significant help in the treatment of patients with chronic renal failure.

The mutagenic activity of paracetamol (PC) was studied on a group of healthy persons (3 men, 8 women) after the simultaneous administration of 3 X 1000 mg of PC and an identical dose of PC + 1000 mg of ascorbic acid within a period of 8 hours. Blood sample tests were made at intervals of 0, 24, 72 and 168 hours. A cytogenetic analysis showed that in 24 hours PC had increased the aberrant cell frequency to 2.77 +/- 0.37 per cent as distinct from 1.68 +/- 0.30 per cent (p less than 0.05) prior to the drug. In 72 hours, the rate of buccal mucosa micronuclei had risen to 0.38 +/- 0.07% against 0.19 +/- 0.06% prior to PC (p less than 0.01). Unscheduled DNA synthesis in peripheral lymphocytes had dropped to T/C = 2.06 +/- 0.54 (p less than 0.01) against 3.16 +/- 0.84 before PC. The lipid peroxidation level in the plasma remained unchanged. Ascorbic acid administered simultaneously with PC had no effect on the changes observed. A further follow-up of other PC side effects is recommended.

A new type of styrene-divinylbenzene copolymer coated with polyhema was tested for biocompatibility and ability to remove bile acid, bilirubin, phenols and cholesterol in dogs with surgically induced biliary obstruction. After 4-hr hemoperfusion through a polypropylene column containing 325 g of resin, performed 7-10 days after the ligature of the cystic and common bile duct, the serum levels of bile acids, bilirubin, phenols and cholesterol decreased by 60.9 +/- 30.3% (p less than 0.001), 34.8 +/- 12.2% (p less than 0.001), 19.4 +/- 15.6% (p less than 0.001) and 15.3 +/- 4.2% (p less than 0.05), respectively. The procedure was well tolerated, no bleeding or other adverse reactions occurred. The average platelet count decreased by 19.4 +/- 15.6% (p less than 0.05). Hemoperfusion through the Czechoslovak resin coated with polyhema is safe and efficient for removal of bile acids and other protein-bound and lipid-soluble substances which accumulate in cholestatic syndromes and hepatic failure. Thus, it may play an important role in the treatment of such events as a method of artificial liver support.

The incidence of arterial hypertension and some clinical and biochemical parameters were followed in relation to hypertension in a group of 156 hospitalized Type-II diabetics. A significant correlation was demonstrated between the values of systolic blood pressure and cholesterol levels (r = 0.30, p less than 0.001), between systolic blood pressure and diabetes duration, and between systolic blood pressure and triglyceride levels in all our patients. Similarly, a significant correlation was found between diastolic blood pressure and the levels of cholesterol (r = 0.27, p less than 0.001), triglycerides and urea. Hypertension was diagnosed in 65% of the group of hospitalized diabetics. Hypertensive diabetics showed a significantly higher proportion of women and a higher mean cholesterol level (6.1 +/- 2.2 mmol/l) compared with the group of diabetics free of hypertension (4.8 +/- 1.4 mmol/l), with the same mean age, diabetes duration and weight. Of the complications of diabetes, the hypertensive group, compared with the control group, were found to have only a significantly higher incidence of cerebrovascular events (31% vs 6%, respectively). The incidence of myocardial infarction and proteinuria were only insignificantly higher in the hypertensive group. We can conclude, on the basis of our results, that the risk factors of atherosclerosis (hypertension, cholesterol, triglycerides) accumulate in the group of Type-II diabetics. This is apparently due to hyperinsulinaemia often present in Type-II diabetics with impaired glucose tolerance. Another factor possibly contributing to the increased incidence of hypertension is the increase in blood viscosity in hyperlipoproteinaemia.

In 50 children followed-up for frequent and repeated respiratory diseases, IFN-alpha production was examined. The ability to produce IFN-alpha correlated with the clinical situation of the children. It was low in children constantly ill and better or even normal in children whose health substantially improved or who were without symptoms during the last two years. The influencing of IFN-alpha production probably could have a favourable effect also on the clinical development of the disease.

Using nephrological, genealogical and molecular genetic methods, the authors examined 85 members of 19 families with autosomal dominant polycystic kidney disease. With the aid of probe 3'HVR, alpha-globin and restriction endonuclease Pvu II, the families were found 95% informative. The rate of diagnostic reliability was also 95%. The authors verified the homogeneity of the disease in the Czech population and the applicability of the probe and endonuclease for molecular gene diagnostics in the population.

38 obese patients with BMI in excess of 35 were monitored, the patients were divided into four groups. The first three were on a strict slimming diet which different as to the energy values (1.38 MJ--2.75 MJ) and the amount of protein (5.58 g N--17.91 g N) per 24 hours. The fourth group was on a starvation diet. Metabolic balance values and resting energy cut put were measured by indirect calorimetry during 16 days of monitoring. In all groups the body weight declined markedly by an average of 8.2-10.5 kg. Resting energy consumption dropped only during absolute fasting. The starvation diet patients exhibited a negative nitrogen balance. Positive nitrogen balance was found in groups on 11.2 g N and 17.91 g N/24 hours. Fat utilization increased and sugar utilization declined in all groups. Protein catabolism declined markedly only in the fasting patients. Summed up, the low-energy protein diet is--in comparison with absolute diet--a more physiological way to achieving weight reduction, in particular, because, despite the loss of weight, a positive weight balance is achieved, too.

Immunofluorescence assay (IFA) and enzyme immunoassay (EIA) for detection of immunoglobulin M (IgM) to cytomegalovirus (CMV) correlated in 88.9%. All but one differences were due to negativity in IFA and positivity in EIA. The agreement between determination of immunoglobulin G (IgG) to CMV by IFA and determination of total antibodies to CMV by EIA was 89.9%. All the differences were due to a mild positivity in IFA and negativity in EIA. The advantage of EIA is in its objective colorimetric evaluation of test results excluding a subjective underestimation or overestimation of the reaction. In addition, EIA gives the result of IgM detection already in 6 hours, while IFA as late as in 24 hours.

Therapeutic success in I-Type diabetes (i.e., glycaemia close to normal levels in an effort to influence favourably the onset and progression of long-term complications), two important preconditions must be met. The patient must receive instruction in safe self-monitoring so he could administer insulin under the supervision of health-care personnel, either using some of the conventional protocols or, in some cases, even unconventional intensified therapy. The aim of the latter approach is good compensation of diabetes and the well-being of a patient to whom insulin administration poses no inconvenience while sophisticated technology helps him or her to overcome stressful situations.