Biomedical subjects
G Fodor
Publications and source records attributed to G Fodor.
[A case of fetal achondrogenesis].
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Static and dynamic pupillometry for determination of the course of gradual detoxification of opiate-addicted patients.
In order to assess the course of methadone (Heptadone) substitution therapy, 29 inpatients at the Vienna Psychiatric University Clinic (21 males, mean age = 27 years, SD 4 years; 8 females, mean age 29.75 years, SD 5.28 years) who were addicted to opium tea or to a mixture of opium and heroin were investigated by means of computer-assisted "static"- and "light-evoked dynamic" pupillometry. Pupillary measurements were carried out before the start of withdrawal, on the 2nd day 48 h after the administration of 10 mg methadone, and again after the maximum and half of the maximum dose of methadone had been administered. The constricted pupils (the effect of opiate) showed dilatation after the withdrawal syndrome appeared, but immediately after the start of the detoxification treatment, as well as 1 day after administration of the maximum methadone dose a decrease of pupillary diameter was observed. The narrowing of the pupil was followed by an increase in pupillary diameter, which peaked 48 h after the last minimal dose of methadone and nearly reached the normal level. The widening of the pupil reflects an increase of noradrenergic activity under conditions of opiate withdrawal. An increase of spontaneous fluctuations was observed during withdrawal and was only inhibited by the maximum dose of methadone. Finally, pupillary dynamics (shortening of latency time and increase of relative changes) improved during therapy. The pupillary measurement corresponded with clinical observations as well as with self-evaluation during treatment. Thus pupillometry seems to be a useful instrument for assessment of treatment of opiate-addicted patients.
[Diagnosis of diabetic macroangiopathy of the lower extremities using rheography].
Rheography (impedance plethysmography) makes it possible to differentiate the normal condition of arteries of the lower extremity from functional and organic affections. The examination of a group of 325 patients with diabetes mellitus revealed that without the use of rheography, i.e. when relying only on examination of the lower extremities by palpation, the presence of macroangiopathy would escape attention in 46% of the affected subjects. Macroangiopathy of an organic character was found significantly more frequently in type 2 (NIDDM) (35%) than in type 1 (IDDM) (9%; p less than 0.03). Its incidence increased in both types of diabetes with the duration of the disease. Moreover it was significantly associated with hyperlipoproteinaemia. The assembled results drew attention to the great diagnostic value of rheography. It permits also to document objectively the effect of treatment focused on macroangiopathy.
[Echography of the hip of the newborn infant].
The authors report on their experience with 2164 US exams of the hip performed over last year on newborns, according to Graf's technique. The babies were divided into 2 groups at first examination: risk/no risk. We considered as risk factors: a positive family history, malposition in utero, abnormalities at birth, and being one of twins. Hips 2a+ and 2a- according to Graf were grouped as "borderline hips" (BLH), extrapolating them from negative and positive cases. BLH have generally shown a tendency to spontaneous normalization, although worsening of the condition was observed in 7.9% of cases. A high incidence of positivity (5.1%) was observed in the no-risk group, versus 9% in the risk group. Moreover, there was low agreement between clinical examination and US findings: the need for US screening is therefore pointed out, not only to promptly detect a decentered hip, but also to prevent the development of juvenile coxarthrosis in case of dysplasia. Premature babies were also studied, and those underweight for their gestational age: the incidence of positive subjects in this group (4.5%) was not higher than that found in the no-risk group (5.1%). We report on the phases of hip normalization as related to stage and therapy. Graf's technique, besides being at present the only reproducible one, represents a method common to all radiologist which allows hip measuring and staging.
[Echographic anatomy of the newborn hip and high-resolution equipment: internal capsular stria and perichondrial gap].
The use of high-resolution US equipment in the examination of the newborn hip allowed the evaluation of a thin echogenic stripe (the internal capsular stripe), which defines laterally the acetabular hyaline cartilage. By means of an anatomo-histological preparation the echogenic stripe can be related to either the capsular circular fibres or the interface between the latter and the hyaline cartilage. The internal capsular stripe, together with the echogenic synovial stripe, precisely delimit the whole acetabular hyaline cartilage. Furthermore, in many babies high-resolution US sometimes fails to demonstrate Graf's "perichondral gap", so that an accurate anatomic knowledge of the hip becomes necessary in the evaluation of acetabular labrum.
[A case of arterio-venous fistula as a late complication of percutaneous puncture of the humeral artery in vertebral angiography: diagnosis using color Doppler].
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[Microcirculation in the subcutaneous layer and in muscles in diabetes mellitus].
The work is focused on the possibility of early diagnosis of diabetic microangiopathy. The authors used examination of microcirculation by the method of tissue clearance of Na 131I. In a group of 106 patients with diabetes thus the microcirculation of the lower extremities in the subcutaneous layer and the calf muscle was examined. A group of 36 healthy subjects served as control. An altered microcirculation was found in 75% type 1 diabetics and in all type 2 diabetics. In those with an altered microcirculation only in 23% type 1 diabetics and in 17% type 2 diabetics organ manifestations of diabetic microangiopathy (i.e. retinopathy and nephropathy) were lacking. It seems thus that altered Na 131I absorption in the lower extremities is an earlier sign of microangiopathic affection than identifiable organ changes. Examination of tissue clearance of Na 131I thus could reveal in time individuals threatened by this complication of diabetes.
["Induced detoxification treatment" of opiate dependent patients--a new therapy concept].
Induced detoxification treatment of opiate addicts by means of naloxone was developed at the intensive care unit of the Department of Psychiatry at the University of Vienna. Two methods were tested 1. Rapid opiate withdrawal by means of a staggered naloxone regimen. 2. Ultrashort opiate detoxification during general anaesthesia using high doses of naloxone. In an open trial 15 patients were treated with staggered doses of naloxone while under tiapride. The various discomforts were satisfactorily reduced, and the detoxification syndrome was limited to 50 hours. In a second open trial 6 patients were administered 10 mg naloxone under general anaesthesia. All naloxone induced withdrawal syndromes can be suppressed by barbiturate anaesthesia. They do not appear even after the effect of the anaesthesia wears off if the patient is kept on a naloxone regimen as long as opiates remain present in the circulatory system. Both methods shorten detoxification treatment and provide smooth transition to a naltrexone maintenance programme.
[Fractionated opiate withdrawal with tiapride and naloxone, a new treatment approach].
To date, no satisfying solution has been found to the problem of how to avoid the distressing withdrawal symptoms accompanying opiate detoxification. By administering staggered doses of naloxone to the patient while under tiapride (Delpral-R), the various discomforts were satisfactorily reduced and the detoxification syndrome could be limited to 50 hours. This study covers 15 patients who had an average addiction history of more than 7 1/e years, and who underwent inpatient rapid opiate withdrawal treatment lasting an average of five days.
[Prevalence of HIV antibodies in intravenous drug-dependent patients 1986 and 1987 in Vienna].
As one of the most important risk groups for HIV infection 82 intravenous drug addicts were tested in December 85/January 86 and 159 in December 86/January 87 for HIV antibody when entering a detoxification programme of our drug addition outpatient clinic. All these drug addicts had used intravenous drugs, mostly opiates. Serum antibodies to HIV were found in 7 (8.5%) of the first sample and in 23 (14.4%) of the second sample. Among seronegative drug addicts a significantly higher use of sterile needles was found than among HIV seropositive drug addicts. Among the seropositive drug abusers a history of intravenous drug abuse outside Austria was found more often than in seronegative drug addicts. The incidence of HIV antibodies in i.v. drug addicts in Vienna appears low in comparison with figures in the Austrian Tyrol (44%), Scotland (33%), Italy (53%) and Switzerland (53%), but similar to England (10%). The low frequency in Vienna could be explained by a significantly higher use of sterile equipment. Furthermore, at the first test period a change in abuse behaviour was found; an increasing number of patients was taking oral opiates exclusively, or reduced intravenous drug intake.
From methylglyoxal to new immunopotentiating ascorbic acid derivatives.
In Szent-Györgyi's search for alpha-dicarbonyl compounds that play an important role in cell regulation, 3-desoxyglucosulose was isolated first from liver but did not prove active. Methylglyoxal came next, however, its toxicity prompted Szent-Györgyi to suggest a combination with ascorbic acid which, indeed led to immunopotentiating enediol acetals although of low stability. Therefore the vinylogue of methylglyoxal, acetylacrolein was coupled with L-ascorbic acid carbanion. This second new reaction, of the aldol-type, led to the stable, potent immunoactive compound, 2-(5-methylfuryl)-3-ketogulonolactone cyclohemiketal that forms a completely surprising H-bond with succinic anhydride and succinimide based on an X-ray study. A third new reaction in which ascorbic acid plays the role of a Michael donor to alpha,beta-unsaturated aldehydes and ketones proved now to be of general validity; it is unexpectedly acid catalyzed and the adducts formed with aliphatic and alicyclic olefin ketones have definite immunopotentiating effect. A brief description of the biological effects of all types of new compounds is outlined.
Effect of methoxy-p-benzoquinones and methoxy-p-hydroquinones on DNA synthesis in Ehrlich ascites tumor cells.
The effects of various methoxy-p-quinones and methoxy-p-hydroquinones on DNA synthesis and thymidine transport in Ehrlich Ascites Tumor Cells was investigated. The inhibitory concentrations (IC50) were in the range of 5 to 65 microM. Adriamycin, used as positive control, had an IC50 of 6 microM. 2,3-Dimethoxy-benzoquinone and -hydroquinone and 2,3,5,6-tetramethoxy-benzoquinone clearly inhibited DNA synthesis at concentrations where thymidine transport was not affected. 2-Methoxy-hydroquinone, 2-methoxy-benzoquinone, 2,6-dimethoxy-benzoquinone, 2,5-dimethoxy-benzoquinone had IC50-values close to the dose inhibiting also thymidine transport. 2,5-Dimethoxy-benzoquinone, 2,3,5-trimethoxy-hydroquinone, 2,3,5-trimethoxy-benzoquinone and 2,3,5,6-tetramethoxy-hydroquinone strongly inhibited thymidine transport without a significant effect on DNA synthesis. Addition of ascorbate enhanced the inhibitory activity of 2,6-dimethoxy-benzoquinone.
[Echography in hip dysplasia in neonates and infants. Echographic anatomy, technic and case material].
The value of hip joint sonography in newborns and unweaned infants is the latest development in the diagnosis of hip dysplasia. Knowledge of the sonographic anatomy makes accurate examination and staging according to Graf's tables possible. Since sonography is non-invasive it can be used for screening and check-up, thus reducing the use of radiography. A personal series of 250 patients is presented.
A new class of synthetic biological response modifiers: the methylfurylbutyrolactones (Nafocare B).
A new class of synthetic biological response modifiers (BRMs) has been produced by combining a highly electrophilic reactant, 2-methyl-2, 5-dihydrofuran (a cyclic acetal of cis-3-acetyl acrolein), with L-ascorbic acid. The parent class of compounds can be referred to as methylfurylbutyrolactones (MFBL), previously termed Nafocare B. This parent molecule is amorphous, has a molecular weight of 252.7, and the chemical name [3,6] cyclohemiketal of 2-(5-methyl-2-furyl)-3-keto-L-butyrolactone. Two crystalline forms were produced by a reaction of the MFBL parent molecule with either succinic anhydride or succinimide, to create MFBL-SA (Nafocare B2) and MFBL-S (Nafocare B3) dimers, respectively. The structure of these compounds has been confirmed by modern methods of analytical chemistry, including x-ray crystallography. All three forms of the MFBLs showed negligible toxicity in single-dose acute LD-50s in mice. Also, the MFBLs did not demonstrate genotoxic activity at 800 mg/kg in the mouse micronucleus assay. The MFBLs are immunostimulatory in assays involving T- and B-lymphocytes, but not in immunoassays on macrophages derived from resident- or thioglycollate-elicited peritoneal exudate cells (PEC). Spleen cells from mice treated 4 days via the intraperitoneal, intravenous, or the oral routes responded significantly over controls to suboptimal stimulatory concentrations of polyclonal mitogens in the lymphocyte stimulation assay. The MFBLs were not mitogenic, since they did not increase DNA synthesis in resting spleen cells from MFBL-treated mice. Antibody production is also amplified by the MFBLs. Mice immunized with sheep erythrocytes, a T-cell-dependent antigen, and treated with MFBLs had a 200-800% increase in the numbers of antibody-producing splenic lymphocytes detected by the Jerne hemolytic plaque assay. Also, mice immunized with soluble bovine serum albumin (BSA), and treated with a MFBL, demonstrated at least a fourfold increase in IgG-specific antibodies to BSA, when compared with controls. To demonstrate effects of MFBLs on macrophages, we used the Fc receptor (FcR) surface marker and superoxide anion assays. Only at the highest in vitro dose of MFBL (16 micrograms/ml) was a significant increase in erythrocyte antibody rosette formation detected, using resident macrophages isolated from PEC. In the superoxide anion release assay neither resident- nor thioglycollate-elicited PECs, obtained from in vivo-treated mice or macrophages treated in vitro, showed increased production of superoxide anion.(ABSTRACT TRUNCATED AT 400 WORDS)