[Interaction of drugs and food components].
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Biomedical subjects
Publications and source records attributed to A Wolf.
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Pathologically low serum total triiodothyronine (T3) concentrations are a characteristic finding in patients with severe non-thyroidal illnesses. No adequate explanation has yet been offered for this phenomenon. We have, therefore, investigated the serum concentrations of total thyroxine (T4), total T3 and total 3,3',5'-triiodothyronine (reverse T3)--the metabolically-inactive metabolite of thyroxine--and of TSH in 13 patients with acute myocardial infarction, in 12 patients with compensated liver cirrhosis, in 9 patients with decompensated liver cirrhosis and in 15 patients with chronic renal failure on chronic intermittent haemodialysis by radioimmunoassay. The values obtained were compared to corresponding values of a normal control group (n - 23). According to our results the decrease in serum T3 combined with normal T4 concentrations in severe non-thyroidal illnesses seems to be a consequence of an alteration in thyroxine degradation. Two different possibilities of alteration can be considered: 1. inhibition of the overall deiodinationof T4, leading to low total T3 serum concentrations with concomitant normal to low reverse T3 serum concentrations (chronic uraemia), 2. a shift in the monodeiodination of T4 towards enhanced reverse T3 production, leading also to low total T3 concentrations, but with a concomitant increase in reverse T3 serum concentrations (myocardial infarction, liver cirrhosis). The results obtained in our patients with liver cirrhosis show, moreover, that this alteration of T4 metabolism depends on the severity of the illness.
A fraction showing tumour-associated antigenic properties has been isolated from pleural effusions of patients with squamous-cell carcinoma of the lung. Purification of the material was accomplished by ion-exchange and affinity chromatography, and by immunoabsorbents. The antigenic activity was monitored by its inhibitory capacity in a specific complement-dependent cytotoxic system. The final fraction has a mol. wt. of approximately 1.7 X 10(5), as judged by gel filtration on Sephadex G200, and the main component appears to be a glycoprotein with N-acetyl-D-glucosamine groups. The most purified antigen preparation exhibited a highly selective capacity to inhibit in the cytotoxic assay and to bind, when labelled with 125I, to 2 specific antisera. The active fractions isolated from pleural effusions fully crossreacted with fractions prepared from squamous-cell carcinoma extracts. CEA and bacterial antigens were not detected in the material, and the presence of alpha-fetoprotein, HLA and blood-group antigens may be ruled out on account of their respective molecular weights.
Anemia is a constant complication of uremia. As it has been suggested that uremic toxins (middle molecules) play an important role in the mechanism of anemia, we studied the activities of three heme-synthesizing enzymes: delta-aminolevulinic acid dehydratase, porphobilinogen deaminase and ferrochelatase. In 26 patients on regular dialysis therapy, all three enzymes had significantly lower values than in normal control subjects. From our results, it can be assumed that the decreased heme biosynthesis in chronic uremic patients might be caused by a lack of erythropoietin or by uremic toxins inhibiting erythropoietin and/or heme-synthesizing enzymes.
72 strains of Salmonella, belonging to 23 different serum types have been isolated during the last three years. These strains come from adult patients admitted to the Infective department of St. Chiara hospital in Trento and from three asymptomatic carriers found among the hospital staff, who have been regularly submitted to microbiological checks. Among the most frequent strains the AA. have found: S. enteritidis and S. typhi murium. Salmonellas, never isolated before, have spread, but they have shown poor adaptation to the environment: among these S. panama, S. infantis, S infantis, S. münchen. S. wien has not found, in the Province of Trento, environing conditions fit for its colonization. S. agona has shown a certain tendency to create a situation of asymptomatic carrier.
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Since January 1976 high-dose methotrexate (HDMTX) therapy has been used in the management of patients with osteogenic sarcoma at the Orthopaedic Department, University of Vienna. 7500 mg MTX/sqm body surface is administrated in a four-hour infusion with citrovorum factor rescue. This therapy is combined with dactinomycin, adriamycin, bleomycin, cyclophosphamide and vincristine in a multi-drug chemotherapeutic program as a prophylactic regimen after surgical treatment of the primary tumour, as well as in the management of metastases. So far, 12 patients have received a total of 46 infusions with HDMTX at montly intervals (6 patients already had widespread metastases). The use of several precautions such as adequate hydration 3 l/sqm body surface fluid), systematic alkalinization of the urine and regular control of the serum MTX level renders HDMTX therapy less hazardous. Five out of the 46 infusions were followed by mild toxic reactions consisting of mouth ulceration, fever and/or bone marrow depression. One out of the 6 patients with metastases and 5 out of the 6 patients receiving HDMTX as a prophylactic measure are without evidence of disease at present. In view of the short observation period, this report is limited to clinical observations only.
Haemodynamics and renal function have been examined before and during i.v. infusion of dopamine (175 microgram/min) in 11 patients admitted as potential kidney donors to an intensive care unit. The findings of the control period revealed an extreme decrease of renal tubular function which points to a cessation of central regulation. The cardiovascular system showed a slight increase of blood pressure and heart rate during dopamine. Urine flow and renal blood flow increased significantly as well as the excretion of sodium while inulin-clearance showed only a minimal rise. The functional renal impairment under conditions of brain death as well as the influence of dopamine on circulation and renal function are discussed. The results indicate that dopamine may exert a favourable effect in preparation of kidney donors for the withdrawal of the organs.
26 hypertensive patients groupded according to the severity-index and the WHO-index were treated with pindolol (monotherapy, 15 mg daily). The response of blood pressure depression was statistically significant, although not always sufficient when judged by clinical parameters. Plasma renin activity responded variably to the treatment in different patients and different groups. In 18 patients a statistically significant increase of serum potassium could be observed. No major side effects of therapy were encountered.
Nonfilamentous forms of Streptomyces granaticolor are formed in a medium with amino acids and glucose. They form filaments again after transfer to a medium with glucose and peptone. The nonfilamentous forms do not produce granaticin. Formation of nonfilamentous forms depends on the concentration of the inoculum, on the cultivation temperature and on the presence of simple sugars. Ultrathin sections revealed atypical septation in the nonmycelial forms and non-uniform accumulation of the wall material.
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Acne and acneform changes are the most frequent occupational diseases in certain industries. As a rule, an oil acne occurs rather seldom in the cordage industry. However, in the factory at Rijeka, 85% of the occupational dermatoses were oil acnes. Mineral oil used in the treatment of hemp was the main etiologic factor. In the ill female workers of that cordage factory, the microclimate, the needle shaped hemp dust, greasy skin, bad working conditions and had hygiene played an important part.
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Although numerous in vitro experiments demonstrated a variable degree of urate bound to human serum albumin and other macromolecules of human plasma, only few data are available on in vivo bound urate. Extracorporal clearances of uric acid, urea nitrogen, creatinine and phosphorus were performed at the beginning, the midtime and the end of 10 hours of hemodialysis. A continuous decrease of uric acid clearance was observed in ratio with the capacity of the artificial kidney used. In contrast to uric acid the clearances of urea nitrogen, creatinine and phosphorus remained constant during the time of dialysis. From the fall of uric acid clearance, the authors conclude a partial binding of uric acid in human plasma.
Following the introduction of massive triple drug therapy with high doses of Endoxan, Proresid and Methotrexat instead of the earlier long-term Endoxan treatment in addition of surgery, percutaneous irradiation and intraperitoneal radio-gold, 3 year survival of advanced stages IIb-IV of ovarian carcinoma rose from 19.6% to 42.6%. The 3 year survival of all malignant ovarian tumors (primary or secondary) rose from 38.3% to 51.0%. Further development led to targeted multiple drug therapy (ultrahigh Endoxan, Proresid/VM26, Methotrexat and Adriblastin) according to oncobiogram. The main side-effects, their control and experience with combined chemotherapy and irradiation are described.
In 22 cases with advanced ovarian cancer, chemotherapy with Adriamycin was employed. All patients had previous operation, triple drug pulsechemotherapy, intraperitoneal radioactive gold instillations and external radiation. A remission was achieved in 36.4% of the patients. The side effects and complication of treatment with Adriamycin are reported and discussed.
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