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Biomedical subjects

Z Nemessányi

Publications and source records attributed to Z Nemessányi.

At least 19 recordsLinked to original sources

[Beneficial effect of the ACE inhibitor captopril in normotensive patients with insulin-dependent diabetes].

The increase of glomerular filtration can often be observed in patients with insulin dependent diabetes mellitus, even in the early stage of the disease and it does not require the presence of microalbuminuria. This phenomenon can be explained by vasoconstriction occurring in the efferent arterioles. Eighteen normotensive, diabetic patients (aged: 28-42) who developed increased glomerular filtration were recruited in this study. The specific objectives were: 1. to study the beneficial effect of angiotensin converting enzyme inhibitor on the glomerular filtration, 2. to evaluate the effect of this treatment on blood pressure and hemodynamic parameters in normotensive, diabetic subjects. After a placebo period of one week, patients were treated orally a daily dose of 3 x 6.25 mg of captopril for twelve weeks. Glomerular filtration was assessed by the isotopic clearance method and blood pressure recordings were taken every 30 minutes throughout a day using an automatic programmable device. Preload, afterload and linear ejection fraction were estimated by echocardiograph, whereas cardiac index was measured by isotopic first pass technique. At the end of the treatment period a significant decrease of glomerular filtration was observed (from 141.9 +/- 10 ml/min to 98.9 +/- 12 ml/min; p < 0.01. Similarly, the afterload exhibited a significant drop due to drug treatment (45.6 +/- 5.8 x 10(3) dyn/cm2 vs. 55.4 +/- 4.7 x 10(3) dyn/cm2 at the end of the placebo period (p < 0.01). However, preload, linear ejection fraction, and cardiac index did not significantly change during the treatment. According to the results obtained from this study a beneficial effect of captopril on the early development of the glomerular hyperfiltration was demonstrated in normotensive diabetic patients who did not develop microalbuminuria. This issue needs to be investigated further in a large scale clinical trial.

Adult↗

[Treatment possibilities for extensive pulmonary embolism as an alternative to the Trendelenburg operation].

The authors describe the clinical course of successfully treated patients with extensive, subtotal pulmonary embolism. After the diagnosis was confirmed by isotopic scan or pulmonary angiography, mechanical thrombus destruction was applied followed by low dose loco-regional thrombolysis in 11 patients by streptokinase. Five patients were treated with ultrahigh dose of streptokinase through peripheral vein, one patient via pulmonary artery catheter and one patient was treated with high dose urokinase by pulmonary catheter in combination with mechanical thrombus destruction by guide wire. All the treatment procedures were proved to be successful. After detailed case reports, the authors review the life saving thrombolytic treatment of acute subtotal pulmonary embolism as an alternative of Trendelenburg operation.

Adult↗

[Management of extensive, potentially fatal, pulmonary embolism].

Extensive pulmonary embolisms were suspected in 11 patients with severe cardiogenic shock admitted to an intensive care unit. The urgently established diagnosis was always based on clinical symptoms and on a complex criteria system elaborated by the authors. The "blind" diagnosis of subtotal pulmonary embolism was confirmed by further noninvasive examinations in 10 cases. During the measures of complex resuscitation, the authors administered high doses of streptokinase in 10 cases and ultra-high dose of streptokinase for one patient. The emergency treatment was successful in four cases.

Adult↗

[Laryngopharyngectomy and free jejunal graft reconstruction in the treatment of hypopharyngeal tumors].

The authors performed a total laryngopharyngectomy due to a hypopharyngeal neoplasm. The continuity of the alimentary tract was restored by the insertion of a vascularized free jejunal graft, using microsurgical technique. On the occasion of this case the authors give a survey of the therapeutical methods used in the therapy of hypopharyngeal tumors, of the indications of the free jejunal transplant and of the technical issues and complications of this procedure.

Humans↗

[Correlations between radionuclide first passage, hemodynamic and respiratory function parameters in cor pulmonale patients].

37 patients with chronic cor pulmonale have been investigated with radionuclide first passage, microcatheter-technique, respiratory function investigation, furthermore blood gas analysis. Significant positive correlation have been found between the pulmonary circulation time and the pulmonary artery pressure; between the pulmonary mean transit time and the pulmonary artery pressure; furthermore between the pulmonary stagnation index was calculated for the characterization of peripheral pulmonary stagnation and the pulmonary artery pressure. Significant negative correlation have been found between the pulmonary circulation time, the pulmonary mean transit time and the vital capacity, the FEV1, furthermore the O2-saturation values. The authors establish, that on the base of the close correlations between the isotopic circulation parameters and the clinical data, the radionuclide first passage investigation is suitable for the demonstration of the current conditions of cardiopulmonary circulation.

Adult↗

Density analysis of scintigram with flow dynamics at bolus radionuclide venography: count correction with velocity.

The authors analyse the difference in the density of dynamic scintigrams produced in radionuclide venography. The difference in density is always connected with the velocity of the radionuclide flow. The lost activity is found after multiplying the count difference calculated from the time activity curve by velocity. The importance of the investigation is that the capacity of different venous channels can be determined in radionuclide venography by this method of calculation.

Arm↗

Application of the parametric scan in the investigation of uteroplacental blood flow.

We developed a new radioisotope technique to measure placental blood flow for the early detection of placental insufficiency. Using the parametric scan, placental perfusion was measured in 80 late-pregnant women. The T-maximum pictures obtained made it possible to differentiate between the vascular and intervillous phases of placental blood flow. The time period of intervillous phase calculated as the percentage of the whole placental Tmax was given as the intervillous perfusion index (IPI). It was demonstrated that the IPI was significantly higher in pregnancies complicated with intrauterine growth retardation (64.2% +/- 16.5%), hypertension (60.0 +/- 15.2) and oedema (57.9% +/- 10.1%) than in the control group (33.7% +/- 10.5%). These data suggest that the first sign of placental insufficiency is the prolongation of the IPI which is likely to precede the quantitative reduction of placental perfusion.

Female↗

Determination of the intervillous perfusion index in pregnancies with intrauterine growth retardation.

The authors developed a new radioisotope technique to measure placental blood flow for early detection of placental insufficiency. Using this method placental perfusion has been measured in 20 healthy pregnant women and in 15 pregnancies complicated with intrauterine growth retardation (IUGR). The T-maximum pictures obtained made it possible to differentiate between the vascular and intervillous phases of placental blood flow. The time period of intervillous phase calculated as the percent of the whole placental T-maximum was given as the intervillous perfusion index (IPI). It has been demonstrated that IPI is significantly longer in IUGR pregnancies (67.0 +/- 14.6) than in the control group (31.6 +/- 10.7). These data suggest that the first sign of placental insufficiency is the prolongation of IPI, which is likely to precede the quantitative reduction of placental perfusion.

Adult↗

Disturbances of cerebrospinal fluid circulation during the acute stage of subarachnoid hemorrhage.

Radioisotope cisternography was performed and the erythrocyte and hemoglobin contents of the cerebrospinal fluid (CSF) were determined within the first 4 days after subarachnoid hemorrhage in 42 patients. The clinical condition of the patients was related to the severity of the CSF circulation disturbances. Thirty-five patients had some degree of disturbance of CSF flow, and only 2 of the 42 patients had normal flow. In 5 cases the cisternograms were inconclusive. The severity of CSF circulation disturbances correlated well with clinical condition. No relationship was found between the number of erythrocytes in the CSF and the development of CSF circulation disturbances. The CSF erythrocyte content did not correlate with the clinical condition. It is suggested that flow disturbances of the CSF during the acute stage of subarachnoid hemorrhage might play an important role in the pathomechanism of the disease.

Adolescent↗

The diagnosis of hypertonic Oddi's sphincter dyskinesia.

The diagnostic possibility of hypertonic Oddi's sphincter dysfunction was evaluated in 100 cholecystectomized and 28 noncholecystectomized patients. An organic lesion interfering with free bile flow was ruled out in every case. The existence of the syndrome, i.e., the dysfunction of the Oddi's musculature, was verified using the morphine-choleretic test combined with either dynamic hepatobiliary scintigraphy or (in selected cases) percutaneous transhepatic cholangiography. Hypertonic Oddi's sphincter dyskinesia can be regarded as an independent clinical syndrome.

Ampulla of Vater↗