Materia medica Polona. Polish journal of medicine and pharmacy最新文献

Twenty-three boys and 30 girls with simple obesity aged 12-16 years were investigated. The values of insulin, C-peptide, glycaemia, gastrinaemia and pancreatic polipeptide (PP) were measured in a fasting state and 30 and 60 min. after meal--at the beginning and after 3 weeks of reductive diet and physical exercise. The study of growth hormone and somatomedin C was deemed relevant to the issue in hand. Considerably higher insulinaemia and C-peptidemia values accompanied by impaired metabolic clearance of insulin and lowered glucose utilization in children with significant accumulation of adipose tissue in the abdominal area (waist/hip ratio p > 0.95), may constitute a possible predictor for diet-controlled diabetes mellitus and cardiovascular system diseases in adult age. Evaluation of adipose tissue in obese children makes it easier to indicate subjects exposed to complications at a later age. Low-caloric diet and physical exercise bring about a decrease in insulin secretion and an increase in its metabolic clearance. At the same time, glucose assimilation by cells is intensified.

Antioxidant defence was investigated in red blood cells (RBC) in 56 patients with 3 different haemoblastoses: polycythemia vera (PV), chronic myelogenous leukaemia (CML), chronic lymphoid leukemia (CLL) with and without anaemia, in 12 iron deficiency anaemia (A) patients and 50 healthy persons. The activities were determined of the following antioxidant enzymes: glucose-6-phosphate dehydrogenase (G6PD), glutathione reductase (GSSG-R), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), catalase (CAT) and MDA levels. Antioxidant defence is decreased and the level of lipid peroxidation are increased in RBC in all patients (PV, CML, CLL, A). Different changes were detected in the antioxidative defence between normal red blood cells and those formed from leukaemic cells clone. In normal RBC in anaemia (CLL, A) opposite deviation of G6PD and GSSG-R activities was observed. In RBC formed from leukaemic cell clone (PV, CML), a simultaneous significant increase in G6PD and GSSG-R activities was found, which indicated activisation of pentose phosphate pathways (PPP) in these pathologies; in anaemia they function less effectively.

The importance of clinical and laboratory parameters which have an effect on postoperative mortality and morbidity was evaluated in 124 patients operated on because of obstructive jaundice. The causes of obstructive jaundice were a malign disease in 38 patients (30.6%) and a benign disease in 86 patients (69.4%). Biliary enteric anastomosis in 66 patients (53%), external drainage in 46 patients (37%), and cholecystectomy in 12 patients (10%) were the surgical techniques of choice for correction of obstructive jaundice. There were significantly high mortality rates in patients with weight loss, more than 10 kg during preoperative the month (p < 0.05); jaundice longer than 21 days, (p < 0.001); and malignancy caused jaundice (p < 0.002). Haematocrite less than 30% (p < 0.05), albumin level below 3 g/dl (p < 0.01), blood urea nitrogen level above 30 mg/dl (p < 0.001), and bilirubine above 10 mg/dl (p < 0.01) were determined as risk factors in mortality. Direct relationships between the number of risk factors, complications, and mortality ratios were determined. One or more complications were determined in patients with more than six risk factors. High mortality rate was also determined in patients who had five and more risk factors. The following factors were evaluated: respiratory, circulatory, renal functions, and infection, and metabolic concomitant diseases, and comorbid scores for each patient were calculated. High rate complications in patients with eight and more comorbid scores and high mortality rates in patients with six and more were also determined. Finally, all these parameters were important in demonstrating postoperative mortality in obstructive jaundice patients. We suggest that surgery after treatment of correctable risk factors decreases postoperative morbidity and mortality.

Influence of four epsilon-aminocaproylaminoacids on prothrombin activation and thrombin activity was examined. Only epsilon-aminocaproylnorleucine markedly inhibited the prothrombin activation in an extrinsic system.

The hepatotoxic effect of 2,4-dichlorophenoxyacetic acid (2,4-D) was investigated. Ultrastructural changes were evaluated under a transmission electron microscope. Certain histoenzymatic reactions were examined (to acid phosphatase according to Gomori (AP) and to succinic dehydrogenase (SD) according to Nachlas) in parenchymal cells of the rat liver in acute intoxication induced by this herbicide. The experiment used 60 male Wistar rats divided into two groups: I-control--18 animals and II--42 animals which received chemically pure 2,4-D acid by gastric gavage in a dose of 200 mg/kg b.w. The animals were sacrificed after 12, 24, 48 hours and 4, 10 and 30 days of the experiment. The results indicate that the administration of 2,4-D acid to rats in a dose inducing acute intoxication leads to histoenzymatic and ultrastructural changes in the liver, which suggest nonspecific reversible adaptive-type damage to parenchymal cells. The changes observed indicate disorders in energetic processes in hepatocytes and are morphological exponents of intense detoxicative processes.

In this study the effect of hypoxia on thrombocytes was investigated in patients with a chronic obstructive pulmonary disease (COPD). 15 Hypoxic (group 1), 15 nonhypoxic (group 2) patients with COPD and 10 healthy persons (group 3) were included in the study. The differences in haemoglobin, hematocrit and PaCO2 values of group 1 and group 2 were insignificant, but there was a significant difference between group 3 and the other two groups. The differences in blood pH values in the above groups were insignificant, but the differences in FEV1, FVC and PaO2 values were significant. We found that thrombocyte aggregation increased significantly in group 1 and group 2. Also the platelet count decreased and mean platelet volume increased significantly in group 1. As a result, we think that in hypoxic patients with COPD, thrombocyte count decreases, volume and aggregation formation increases and oxygen plus antiaggregation therapy may have positive effects on the survival and life quality of these patients.

The concentrations of fibrinogen (Fb) and the activities of factor VII (F VIIC) and antithrombin III (AT III) both in men less than 55 years old with a history of myocardial infarction (MI) and with normolipemia (MI-NLP) or hyperlipoproteinemia (MI-HLP) and in their sons have been measured. A significantly higher levels of Fb were found in both MI groups. Significantly higher levels of F VIIC and AT III were found only in the MI-NLP group. No lipid or haemostatic disorders were noted in sons. Furthermore, a positive correlation between the level of F VIIC and triglycerides (TG) or total cholesterol (TCh) in the patients and sons was revealed. A positive correlation was found between: (a) Fb levels in MI-HLP patients and in their sons; (b) TG levels in MI-HLP patients and in their sons; and (c) AT III activity in MI patients and in their sons. Fibrinogen appears to be associated with ischemic heart disease more closely than factor VII, the latter being strongly linked with hypertriglyceridemia. Elevated activities of AT III may reflect the haemostatic response to the prothrombotic state in IHD on the one hand whereas they may contribute to the development of IHD on the other.

A case of voiding difficulties was investigated. Other than usual prostatic obstruction or urethral stricture, a small mass at the anterior region of the bulbous urethra was present. Detailed investigation by urethroscopy, biopsy, CT imaging and ultrasonography revealed epidermoid carcinoma of the urethra.

Purpose: Suprapubic or endoscopic Burch colposuspension is a preferred technique for the treatment of stress urinaly incontinence in selective cases. We have attempted to investigate the early and long term results of suprapubic surgery for the treatment of stress incontinence and cystocele.

Patients and method: 98 patients with grade 1-2 stress urinary incontinence and grade 1-2 cystocele were included in this study. Preoperative testing include the Boney test, pad test, cystography, cystometry, leak point pressure, and urethral pressure profile studies.

Results: Our success rate was 93% three months after surgery for stress incontinence, 81% after twelve months (range 11 to 14) and 67% after 48 months (range 44-55). Grade 1 cystocele was corrected with a 76% success rate and Grade 2 cystocele was corrected with a 70% success rate 3 months after surgery. Twelve months later, these rates were 68% and 56% respectively. At the time of the last control these rates were 59% and 37% for cystocele, respectively.

Conclusion: Burch colposuspension is an effective method for the treatment of Grade 1-2 stress incontinence and grade 1 cystocele in the early and late control examinations, but is not effective in patients with grade 2 cystocele in the long-term follow up examinations.

Monocytes may contribute to a coagulation process by expression of the tissue factor and by synthesizing factors V, VII, X and XIII. Cultured blood monocytes also express both the tissue plasminogen activator and the plasminogen activator inhibitor I. The present study assesses the ability of human monocytes to secrete protein C and its cofactor protein S, which are potent inhibitors of the clotting cascade. Monocytes derived from the blood of healthy volunteers and prepared according to Boyum were cultured for up to 36 hours with or without lipopolisaccharide from Escherichia coli. After different times of incubation, the concentrations of proteins C and S in the supernatants were measured in order to determine synthesis of proteins, monocytes were cultured in the presence or absence of cycloheximide, the protein synthesis inhibitor. The concentration of protein C was estimated by means of the ELISA Protein C test (Boehringer Mannheim). Protein S concentrations were measured by rocket immunoelectrophoresis according to Laurell, using monospecific antisera (American Diagnostica Inc., N.Y.). The study showed that human monocytes, when stimulated by lipopolisaccharide, release proteins C and S in vitro. The concentration of these proteins in the culture supernatants markedly increased with time during the 36-hour observation. The supernatants obtained from the culture of unstimulated monocytes did not contain detectable quantities of the investigated proteins. The exposure of the cells to cycloheximide did not suppress the release of proteins C and S. In conclusion, our results suggest that monocytes are not able to synthesize proteins C and S. They can only release these factors. Furthermore, monocytes may be responsible for coagulation due to the inactivation of factors Va and VIIIa by protein C.