Download full text in PDF format (260 kB)Electronic Library of Scientific Literature - © Academic Electronic Press
Volume 102 / No. 8 / 2001
Strapkova A, Nosalova G
Department of Pharmacology, Jessenius Faculty of Medicine, Comenius University,
Martin, Slovakia.
bll@fmed.uniba.sk
Background: Nitric oxide is a neurotransmitter of the inhibitory
nonadrenergic noncholinergic mediation in the respiratory system. Its
participation in the regulation of airways functions is determined by its level
in the organism.
Main purpose: We examined participation of nitric oxide in the changes of
the airway reactivity evoked by toluene exposure as the source of the free
radicals. The changes of nitric oxide level in the organism were evoked by
administration of its indirect donor isosorbide dinitrate. Thiol groups were
provided by administration of antioxidative mucolytic N-acetylcysteine.
Methods: Used drugs — isosorbide dinitrate (5 mg/kg b.w.) and
N-acetylcysteine (300 mg/kg b.w.) were administered intraperitoneally or by
inhalation 30 minutes before each exposure to the toluene vapours. The control
group was not treated with drugs. After toluene exposure (2 hours in each of 3
consecutive days) tracheal and lung strips smooth muscle reactivity to histamine
was observed under in ”in vitro” conditions.
Results: The administration of isosorbide dinitrate decreased especially
the lung strip smooth muscle reactivity to histamine. We revealed more
expressive effect of the pretreatment with intraperitoneally administered
isosorbide dinitrate in the comparison with inhalation. Simultaneous
pretreatment with N-acetylcysteine intensified beneficial effect of isosorbide
dinitrate probably by increasing of the intracelullary level of thiols.
Conclusion: In our experimental conditions possible participation of
nitric oxide in changes of airways smooth muscle reactivity after exposure to
the toluene follows from results, as well as the importance of thiol groups for
the activity of its indirect donors. (Fig. 6, Tab. 3, Ref. 35.)
Key words: toluene, hyperreactivity, nitric oxide, isosorbide dinitrate,
N-acetylcysteine.
Bratisl Lek Listy 2001; 102 (8): 345–350
Download full text in PDF format (260 kB)
Sebekova K, Spustova V, Opatrny K Jr., Dzurik R
Institute of Preventive and Clinical Medicine, Bratislava, Slovakia, and
Dialysis Center, Department of Internal Medicine, Charles University, Plzen,
Czech Republic.
sebekova@upkm.sk
Background: In patients suffering from chronic renal insufficiency (CRI)
serotonin (5HT) metabolism is impaired, and plasma 5-hydroxyindoleacetic acid
(5HIAA) levels (main metabolite of 5HT) are increased.
Aim: In this study we aimed to give a detailed description of peripheral
serotonin metabolism in healthy subjects and patients with CRI, and to evaluate
the efficacy of hemodialysis in the elimination of cumulated 5HT and 5HIAA.
Methods: 5HT (platelet rich plasma, platelet poor plasma, urine, HPLC
with electrochemical detection) and 5HIAA (plasma, urine, HPCL with
electrochemical detection) levels were evaluated in 14 conservatively treated
(CT) and 12 hemodialysed (HD) patients with CRI and were compared to those of 60
healthy volunteers (HV).
Results: In patients with CRI accumulation of 5HT and 5HIAA in plasma
with no changes in platelet 5HT content was revealed. 5HT renal and fractional
excretion (FE) was markedly decreased in CRI. FE-5HT was <1 in all
investigated subjects, indicating its reabsorption in proximal tubules, or local
degradation to 5HIAA. Due to the increased filtration load renal excretion of
5HIAA was not altered in CT patients, however it was decreased in HD patients.
The relative participation of glomerular filtration in 5HIAA renal excretion
increased in CRI. FE-5HIAA >5 was found in 20 % of HV and 15 % of CT,
pointing indirectly to 5HIAA intrarenal production. In CRI FE-5HIAA decreased.
HD did not eliminate accumulated 5HT and 5HIAA effectively.
Conclusion: Increased levels of 5HT and 5HIAA might exert metabolic
effects contributing to the clinically manifested impairments characteristic for
uremic syndrome. (Tab. 3, Fig. 3, Ref. 27.)
Key words: serotonin, 5-hydroxyindoleacetic acid, chronic renal
insufficiency, hemodialysis, renal excretion.
Bratisl Lek Listy 2001; 102 (8): 351–356
Download full text in PDF format (325 kB)
Kopecna L
Ist Children’s Internal and Oncological Clinic Medical Faculty, Masaryk
University, Brno, Czech Republic.
lkopecna@med.muni.cz
The current state: Children with curable cancer are potentially at risk
of long-term renal sequelae. The nephrotoxicity is considered dose related and
includes a variable reduction of glomerular filtration rate along with tubular
dysfunction.
Subjective: The aims of the present study were: to analyse kidney damage
as well as the clinical course in children treated for ALL, to determine what
type of nephrotoxic damage is most frequent in relation with the used treatment,
to determine possible risks of acute and chronic nephropathy of anticancer
therapy, to standardise evaluation of kidney function in children after their
complex antitumourous treatment has finished.
Methods and material: We examined a group of 36 children ( 21 boys, 15
girls, average age at diagnosis of ALL 6.9 years)) treated for ALL using the
therapeutical protocol ALL BFM 90.The average period after the treatment had
finished was 48 month. The following parameters were examined: urinalysis and
urine sediment, clearance of creatinine, tubular resorption, ultrasound of
kidneys, 24 hrs proteinuria (PU) and urine concentration of albumine,
transferine, alpha-1-microglobuline and Tamm-Horsfall protein. Concentration
function of kidneys was examined by test with DDAPV.
Results: After finish of cytostatic therapy had 19 patients (52.8 %) PU.
Glomerular PU was found in 3 children (15.8 %), in 3 children (15.8 %) was found
mixed PU and 13 children (68.4 %) had tubular PU. Reduction of GFR had 5
patients (13.9 %) and 19 patients (52.8 %) had reduction of DDAPV test.
Conclusion: Sensitive laboratory analysis of proteinuria is required for
timely detection of the most frequent type of kidney damage in the course of
treatment with cytostatics but also other concurrently administered drugs. Thus
we can reliably detect mainly patients with glomerular/mixed proteinuria who are
potentially imperilled by the risk of the development of chronic renal failure.
If there is higher level of glomerular/mixed proteinuria even after the
treatment has finished, the patients have to undergo another nephrological
monitoring. (Tab. 3, Ref. 20.)
Key words: nephrotoxicity, acute lymphoblastic leukemia, proteinuria, kidney
function.
Bratisl Lek Listy 2001; 102 (8): 357–360
Download full text in PDF format (305 kB)
Matejcik V, Steno J, Benetin J, Kuchar M
Department of Neurosurgery, University Hospital, Faculty of Medicine, Comenius
University, Bratislava, Slovakia.
bll@fmed.uniba.sk
Starting point: In this retrospective study, we present the results of 40
surgeries of 40 patients that within the period of 15 years, i.e. from 1985 to
1999 were provided the treatment of 40 lesions of n. fibularis, historically
treated as problematic in terms of successful healing. The work provides the fundamental
lines of their surgery treatment.
Material and methods: From the total number of 40, external neurolysis
was performed to 20 patients. The remaining 20 patients were provided with
reconstruction surgeries of the injured nerves, while 8 surgeries was done by
suture of peripheral nerve and 12 surgeries were performed by nerve graft, in
cases of complete and persisting neurological deficit and absence of action
potential at EMG. The mechanism of lesion included the damages of nerve
from elongation, with or without fracture, ”sharp” or ”blunt” lesions,
lesions of shooting, compressions and iatrogenic injuries. If the spontaneous
adjustment did not occur within the period of 2—6 months after the lesion, the
patients underwent surgery. We performed the analysis of the efficiency of the surgical
intervention depending on the following parameters: period of surgery from the
lesion, patient’s age, nature of lesion, degree of lesion, type of surgery
intervention.
Results: With 27 of 40 an effective adjustment was achieved preventing
the sagging of the foot trace and with 25 of 40 protective sensitivity appeared.
After neurolysis with 18 of 20 patients (90 %) we achieved effective degree of
adjustment in spite of heavy pre-surgical motor deficit. With 8 patients an
”end to end” suture was performed and with 6 (75 %) the degree of adjustment
was 3 or higher. 12 patients requested reconstruction surgeries with the help of
nerve grafts, the length of grafts varied from 4 to 20 cm. The grafts were
shorter than 5 cm with 2 patients, 1 with cut lesion and 1 patient with
iatrogenic lesion. With both patients the function was adjusted to the degree
M4. With 1 of 4 patients (25 %) with the graft of 6 to 12 cm and with none of 6
with the grafts from 13 to 20 cm the adjustment of the degree 3 or higher
was not achieved. In this cases, however, we noticed partial adjustment of
trophic and tonus, however at the absence of motor adjustment.
Conclusion: The pre-surgical and persurgical examinations are
indispensable conditions for obtaining optimal results. It is worth of
mentioning that surgical treatment proximal lesins of n. fibularis yielded
better results than treatment of more distal lesions in the area of knee. (Tab.
5, Ref. 20.)
Key words: lower extermity nerve lesions, neurolysis, nerve suture, nerve
graft.
Bratisl Lek Listy 2001; 102 (8): 361–364
Download full text in PDF format (133 kB)
Sleiman OI, Murin J, Ghanem WM
1st Department of Internal Medicine, University Hospital, Faculty of Medicine,
Comenius University, Bratislava, Slovakia.
Ossamasleiman@hotmail.com
The problem of heart failure (HF) has become a topic of great interest. Until
recently, the use of beta-blockers in patients with HF was considered as a
contraindication. Times have changed and the contraindicated drug is now an
advised and preferred one to be used in HF patients with certain advised
recommendations for its use in a safe and beneficial way. Still we need to
emphasize the benefits of these agents in order to achieve more application in
HF patients.
Here we try to stress the proved beneficial effects of beta-blockers by major
studies in HF patients, and to supply the reader with practical information
regarding the use of these agents with a look at the frequency of using them and
the possible reasons behind their underuse. The files of heart failure patients
admitted to 1st Internal Department in the University Hospital in Bratislava in
the period between January and December 1997 were checked to show the magnitude
of using beta-blockers in them. Among 150 patients admitted during the above
mentioned period only 30 patients (20 %) received beta-blockers. It seems that
beta-blockers have to be used in all patients with HF with reduced ejection
fraction unless a real contraindication exists, but the actual data shows that
beta-blockers are still underused. (Tab. 2, Ref. 30.)
Key words: heart failure, beta-blockers, mortality, sudden death.
Bratisl Lek Listy 2001; 102 (8): 365–369
Download full text in PDF format (137 kB)
Benesova Y, Niedermayerova I
Department of Neurology, University Hospital Brno-Bohunice, Czech Republic.
bll@fmed.uniba.sk
The authors used a new method of evaluating clinical disability — Multiple
Sclerosis Functional Composite (MSFC). Three quantitative tests, for the upper,
lower extremities and cognitive functions, were used in 90 multiple sclerosis
(MS) patients. The correlation between these results and Expanded Disability
Status (EDSS) has shown that in slightly disabled patients there was achieved
relatively high correlation especially for the upper extremities function. Their
function remains saved for comparatively a long time. During the gradual
deterioration of clinical status high correlation between the severity of
disability and lower extremities function was achieved. The lowest degree of
correlation was observed in cognitive functions, which are monitored more
senzitively by MSFC method than by EDSS. The best correlation was revealed in
seriously disabled group, not in slight and moderate affections, because EDSS
evaluates these functions only marginally and cannot catch discover the
beginning of the cognitive deficit. (Tab. 1, Ref. 4.)
Key words: multiple sclerosis, EDSS method, MSFC method, correlation MSFC
and EDSS.
Bratisl Lek Listy 2001; 102 (8): 370–371
Download full text in PDF format (119 kB)
Haviarova Z, El Falougy HAK, Killingerova A
Department of Anatomy, Faculty of Medicine, Comenius University, Bratislava,
Slovakia.
haviarova@fmed.uniba.sk
Work in the form of anatomical casuistry is presenting and describing the
atypical course of the median nerve found in both upper limbs of one of the
cadavers in the Department of Anatomy of Medical Faculty of Comenius University
in Bratislava. This atypical course was found during the students’ dissection
of the peripheral nerves and vessels.
This non-standard course of the median nerve is compared with standard course
described in anatomical literature and atlases, and confronted with the possible
variations of the median nerve and its course described by the available
literature. (Fig. 4, Ref. 4.)
Key words: median nerve, course.
Bratisl Lek Listy 2001; 102 (8): 372–373
Download full text in PDF format (643 kB)
Wawruch M, Harnicarova A, Macekova L, Tisonova J, Biss B, Kriska M
Institute of Pharmacology, Medical Faculty, Comenius University, Bratislava,
Slovakia.
wawruch@hotmail.com
Opinions on antibiotic treatment of salmonella gastroenteritis are still
different. Many authors support an opinion that antimicrobial treatment has no
effect on salmonella elimination. The authors of the study have tried to proove
that fluoroquinolones shorten the elimination of salmonellae and therefore they
are useful not only for the treatment of salmonella gastroenteritis in
immunocompromised patients to prevent sepsis and extraintestinal manifestations
of the infection, but also for eradication of salmonellae in food industry
workers, whose carrier state might exclude them from their work. (Tab. 3,
Ref. 10.)
Key words: salmonella, carrier state, quinolones, antimicrobial agents, food
industry workers.
Bratisl Lek Listy 2001; 102 (8): 374–376
Download full text in PDF format (128 kB)
Kuzela L, Sutka J, Vavrecka A
Clinic of Gastroenterology, Slovak Postgraduate Academy of Medicine, St. Cyril
and Method’s Hospital, Bratislava, Slovakia.
kuz.laco@pobox.sk
Background: Endoscopic ultrasonography (EUS) is a method that takes the
advantage of a combination of endoscopy and ultrasound, where a miniature probe
that functions as a transducer (which functions as both a transmitter and a
receiver of ultrasound), is incorporated in the tip of the endoscope. From the
introduction, this modality has found it s uninterchangable place all over the
world not only in the diagnosis, but also in the therapy of gastrointestinal
diseases and the diseases of the surrounded structures and organs. Indications
for EUS can be simply divided into three main categories: submucosal
abnormalities, staging of tumors of the gastrointestinal tract and
pancreatobiliary diseases. In December 2000 we began at the Clinic of
Gastroenterology of Slovak Postgraduate Academy of Medicine at St. Cyril and
Method s Hospital in Bratislava, Slovak Republic with the EUS evaluation with
radial mechanical probe, as the first one in the Slovak Republic. In this
article we describe our first experience with the EUS at our clinic.
Conclusions: All together 64 patients were evaluated from December 2000
to the end of March 2001 from all over the Slovakia. In this article we describe
in more detailed form the indications and also the findings in our group of
patients. (Short communication)
Bratisl Lek Listy 2001; 102 (8): 377–379
Download full text in PDF format (123 kB)
Ferencova E, Kukurova E
Faculty of Medicine, Comenius University, Bratislava, Slovakia.
ferencova@fmed.uniba.sk
Teaching subject physics at the university level represents a specific
didactic transformation of the scientific field — physics. The determination
of the content, extent, used methods, mutual relation to other subjects of
curriculum as well as to the entrance knowledge of students are the most
important parts of pedagogical activities in the educational process.
Based on own experiences, successes and mistakes in teaching so-called medical
physics the authors discuss didactic procedures which should support the
interest and creativity of students. Some changes in the structure of physics
education are recommended. The usefulness of the international collaboration in
the framework of projects such as TEMPUS, ERASMUS is also remembered.
Bratisl Lek Listy 2001; 102 (5): 380–381
Download full text in PDF format (118 kB)
Panchovska M, Sheitanov Y, Martinova F
Clinic of Rheumatology, Medical University, Sofia, Bulgaria.
mar_pan@abv.bg
The primary Sjögren’s syndrome (pSS) is an autoimmune exocrinopathy which is presenting with progressive dryness of the eyes and the mouth, changes in the parotid glands and not rarely with systemic (extraglandular) manifestations. The development of the immunogenetics proved that the course of the disease is genetically determined. HLA-antigens, associated with pSS differ in the separate races, populations and ethnic groups.
Bratisl Lek Listy 2001; 102 (8): 382
Download full text in PDF format (114 kB)
Electronic Library of Scientific Literature - © Academic Electronic Press