Biomedical subjects
Publications and source records attributed to S Szabó.
Experiences obtained with the electroconvulsive treatment of a schizophrenic patient suffering from severe haemophilia A are reported. No haemorrhagic complications were observed. According to our experiences electroconvulsive therapy can be applied also in severe haemophilia A if satisfactory replacement therapy can be ensured. Similar case has not been found in the literature.
Blood flow velocity of 24 patients in state of the brain death were examined by transcranial Doppler sonography. Authors expound the characteristic velocity-pulse graphs recorded in progressively increasing intracranial pressure and their chronology as well. The different forms of the oscillating flow and their successive development are described. The oscillating flow, the systolic spikes and the so called "zero Flow" are the transcranial Doppler signs of the ceased cerebral blood flow, and these signs can be used as one of the evidence of the brain death.
The value of transcranial Doppler sonography is demonstrated in two infants with an elevation of intracranial pressure (ICP). One of them suffered from hydrocephalus and ICP increased because of her VP shunt-insufficiency. In the other case status epilepticus caused brain oedema and a rise in intracranial pressure. In both cases, transcranial Doppler sonography showed a decrease in blood flow (CBF) velocity and an increase in the Pourcelot index in the middle cerebral artery. Quick or gradual reduction of the ICP led to an increase in CBF velocity and a decrease in the Pourcelot index. On the basis of experiences of the authors, transcranial Doppler sonography is a valuable method of verifying the elevation of ICP. It is suitable for measuring the effect of treatment necessitated by the elevation of ICP. The method is non-invasive, quick and it can be freely repeated. Therefore it is applicable for monitoring the dynamic of ICP.
Transcranial Doppler Sonography. Authors publish the experiences gained by 2300 examinations with Transcranial Doppler Sonography (TDS) which is a new, noninvasive ultrasound method to examine cerebral blood flow velocity in the basal arteries. The theoretical ground and the technique of the investigation is detailed. Mean values of blood flow velocity in the middle cerebral artery of 88 healthy volunteers in different age groups are reported. Authors stress on the numerous advantages of the utilization of this technique. Different pathological alterations of blood flow velocity and characteristic types of velocity-pulse figure are accounted. At last illustrative case reports proving the importance of TDS in different pathological states are presented.
A phosphoprotein phosphatase (PPPase) is inhibited in rat duodenal mucosal cells very early after a single s. c. injection of the duodenal ulcerogens cysteamine, propionitrile and mepirizole. The effect seems to be independent of their effects on gastric acid secretion and on duodenal suppression of alkaline secretion. The enzyme inhibition is dose- and time-dependent under in vivo conditions. The inhibition of the PPPase activity is enzyme-selective at the level of mucosal cells in the duodenum. Under in vitro conditions, none of the duodenal ulcerogens inhibited PPPase activity. The results indicate that the effect of the ulcerogens on PPPase activity is probably exerted indirectly. When given simultaneously in vivo, propionitrile attenuated the inhibitory effects of cysteamine on the PPPase activity. However, both propionitrile and cysteamine potentiated the effect of mepirizole on PPPase depletion. These data indicate that cysteamine and propionitrile may act through the same mechanism when depleting PPPase activity. The mechanism of the decrease of duodenal protein phosphatase activity by mepirizole is probably different from the other duodenal ulcerogens.
During the past 2 years cerebral blood flow velocity was measured serially first of all in the middle cerebral arteries and in the bifurcation of the carotid arteries, less frequently in the other basal arteries by transcranial Doppler sonography in 36 head injured patients selected from 87 cerebral contusions and intracranial haematomas. Raised flow velocity referring to cerebral vasospasm was observed in 14 (40%) of 36 cases. Vasospasm developed between the 2nd and 8th days in the basal arteries, never on the first day. It was classified as slight (over 120 cm/sec) and sever (over 160 cm/sec) in the case of vasospasm lasting for several days. Development of vasospasm could be justified in 6 from 14 control angiographies. Authors' observations are compared with some literary data of traumatic vasospasm. The theoretical significance and practical usefulness of transcranial Doppler sonography in the study and follow up of the blood flow of the injured brain, especially in traumatic vasospasm, are emphasized.
Gastric cytoprotection is a concept or phenomenon, and not a single magic mechanism of action of unusual compounds. It refers to prevention of acute hemorrhagic erosions where the superficial epithelial cells are not directly protected but are rapidly replaced by restitution in microvascular injury in subepithelial capillaries is prevented or diminished and blood flow is maintained. This gastroprotection achieved by prostaglandins (PG), sulfhydryls (SH) and non-SH antioxidants is thus real but relative by target, mechanisms and in time. PG and SH are the only two chemical entities with both pharmacologic and biochemical relevance, i. e., endogenous concentrations of PG and SH derivatives may be measured biochemically and correlated with the degree of gastroprotection. Despite differences in the chemical mechanisms of action (e. g., SH unlike PG scavenge free radicals and may directly influence SH-sensitive receptors, enzymes and membrane permeability), the structural and functional targets for both groups of compounds are essentially the same: prevention or reduction of microvascular injury in subepithelial capillaries, maintenance of blood flow which allows the energy-requiring rapid epithelial restitution to repair the superficial epithelial defect. This reductionist, critical and mechanistic overview highlights the recent developments and the persisting problems in study design, definitions and interpretation of results as well as some critical questions related to the concept of gastric cytoprotection.
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This paper reviews the recently discovered role of sulfhydryls and early vascular injury in the pathogenesis of acute gastric mucosal injury. In the rat ethanol caused a dose-dependent decrease in nonprotein sulfhydryl concentration in the gastric mucosa within 1-5 min following an intragastric dose. These biochemical changes were accompanied by increased vascular permeability in the glandular stomach as revealed by the measurement of extravasated Evans blue injected i.v. prior to the administration of ethanol. Morphologic evidence of vascular injury was provided by labelling of damaged blood vessels in the stomach following the i.v. administration of colloidal particles in the form of india ink or monastral blue. The functional and structural damage to capillaries and venules in the glandular stomach was also maximal within 1-6 min after 1 ml of 75 or 100% ethanol given orally. Pretreatment with sulfhydryl (SH) containing drugs (e.g., L-cysteine, N-acetyl-L-cysteine, cysteamine, dimercaprol) or prostaglandin (PG) F2 beta prevented the ethanol-induced increase in vascular permeability, the labelling of blood vessels with vascular tracers, and the subsequent haemorrhagic erosions. The desquamation of superficial epithelial cells, however, was not markedly modified by either SH or PG compounds. This organoprotective effect of SH and PG drugs was virtually counteracted in adrenalectomized rats that exhibited "vascular fragility". Glucocorticoid treatment restored the response of adrenalectomized animals. Thus, a SH- and glucocorticoid-sensitive early vascular injury seems to be of major significance in the pathogenesis of haemorrhagic gastric erosions and SH-containing compounds represent a new group of cytoprotective or organoprotective agents.
Concentrations of albumin, IgG, IgA, IgM, alpha 1-acid glycoprotein, alpha 1-antitrypsin, alpha 2-macroglobulin, transferrin, haptoglobin, and coeruloplasmin were determined by radial immunodiffusion in the blood sera and bronchial washings of 8 patients without clinical, radiologic or bronchoscopic evidence of lung diseases. The local production of the proteins was calculated with a formula used by Deuschl and Johansson for the estimation of local synthesis of bronchial immunoglobulins. The formula was completed by a reduction factor established by the authors, based on their previous investigations. The calculations indicated that the individual proteins were secreted locally in various percentages of the total amount found in the secretion, as follows: IgG, 37%; IgA, 84.5%; transferrin, 44.5%, alpha 1-antitrypsin, 15.2%; coeruloplasmin, 11.3%. Local synthesis of IgM was found only in 3 patients. The alpha 1-acid glycoprotein and the haptoglobin do not seem to be secreted locally by the normal bronchial mucosa; they reach the mucus from blood only, through ultrafiltration.
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