[Insulin production of isolated fresh and cryopreserved islands of Langerhans of rats]. / Untersuchung der Insulinproduktion der isolierten frischen bzw. kryopräservierten Langerhans-Inseln von Ratten.

The effect of glucose and Domperidon (R 33812, pharmaceutical factory Gedeon Richter, Budapest) on the insulin secretion were investigated in the isolated islets of Langerhans of rats. The insulin secretion was increased by glucose and also by Domperidon, however, in a smaller size. The insulin secretion of cryopreserved islets--stored in liquid nitrogen of -196 degrees C during 2-6 months--was equal with the secretion of fresh isolated islets. Thus the cryopreservation had not impaired the insulin secretion ability of the islets.

[Transplantation of islands of Langerhans: inclusion of living cells into a polymer forming a net-like structure]. / Fragen zur Transplantation von Langerhans-Inseln: Der Einschluss von lebenden Zellen in ein Polymer, welches eine netzförmige Struktur bildet.

A two-component polyacrylic amide gel forming a net-like structure was built up on pancreatic cells. In such a way the transplanted cells could be protected from the damage by immune protein with big molecule. The method was tested in yeast cells before, human erythrocytes, and wether erythrocytes. It was shown that the polymerisation and the inclusion method do not influence essentially the vitality of the examined cells. It was demonstrated by means of the complement fixation reaction that the included erythrocytes cannot be damaged by the immune protein with big molecule. Metabolic processes of the included pancreas beta cells were provable by diffusion. The experiments promise that the included cells survive after the transplantation and the polyacrylic amide gel protects the cells from the impairing effect of the immune protein.

Respiration paralysing and circulatory effects of a new non-depolarizing relaxant, pipecurium bromide, in anaesthetized dogs.

The effect of a new sterane-structure, non-depolarizing muscle relaxant 2 beta,16 beta-bis(4'-dimethyl-1'-piperazino)-3 alpha,17 beta-diacetoxy-5 alpha-androstane dibromide (pipecurium bromide, RGH-1106, Arduan) was studied in 42 mongrel dogs under general anaesthesia (ether, halothane, methoxyflurane, thiobutobarbital, hydroxydione and dehydrobenzperidol-fentanyl (NLA II). Onset and duration of action and the presence of circulatory side effects were examined. It was found that the mean onset of respiration paralysing action was 156.1 s and apnea lasted for 38 min. In the thiobutobarbital group apnea lasted for 74 min. Arterial systolic blood pressure and central venous pressure did not change, but the heart rate was mildly decreased by pipecurium bromide. ECG intervals (PQ, QT and TP) did not change considerably, and the variations ran parallel with the prolongation of RR intervals due to the decrease of heart rate. Pipercurium bromide is a non-depolarizing muscle relaxant of medium duration, without any significant circulatory effects. Its duration of action was prolonged in the presence of thiobutobarbital, indicating a drug interaction between the two preparations.

First clinical experience with a new neuromuscular blocker pipecurium bromide.

The clinical trial of the new non-depolarizing muscle relaxant 2 beta,16 beta-bis-(4'-dimethyl-1'-piperazino)-3 alpha,17 beta diacetoxy-5 alpha-androstane dibromide (pipecurium bromide, RGH-1106, Arduan) was performed on 80 patients who had to undergo medium and major size intraabdominal operation on the basis of chronic surgical indication. Four types of general anaesthetic methods were applied, neuroleptanalgesia, halothane, halothane-fentanyl combination and hydroxydione. The clinical applicability of pipecurium bromide was tried to establish the dose needed for complete muscle relaxation initially and repeatedly and the effect of antagonist drugs on the muscle relaxation. We investigated the duration of the first and repeated dose of the relaxant. Heart rate and arterial blood pressure were measured, mean arterial pressure and pulse pressure were calculated. In 10 patients of the halothane group the behaviour of some haemodynamic parameters was investigated. The changes of acid base parameters, blood gases, serum electrolytes and blood sugar were also observed. The administered doses were initially 3.88 mg/h, repeated doses 2.32 mg/h, this means 0.052 mg/kg body weight initially and 0.026 mg/kg body weight repeatedly The duration of effect after the first dose was 53 min, after the repeated doses 45 min. There were no direct effects on heart rate and arterial blood pressure. It did not affect myocardial contractility or work function, there was no remarkable changes in cardiac output. There were no direct metabolic changes due to pipecurium bromide. The relaxant has no histamine releasing effect. At the end of the anaesthesia the effect can be antagonized with neostigmine. During our observations there were no side effects or allergic reactions caused by pipecurium bromide.

[Structure of adrenal glands removed for hyperandrogenism and their hormone production in tissue culture]. / Hyperandrogenismus miatt eltávolított mellékvesék szerkezete és hormontermelése szövettenyészetben.

Authors studied the surgically removed adrenals of a 16 year old girl with hyperandrogenism in tissue culture. The majority of cells in the initial culture was similar to the cells of the normal human adrenal. In the 6 weeks tissue culture the morphology of the cells has shown an alteration. The majority of them contained a small number of lipid droplets, abundant quantity of lysosomes and autophage vacuole. At this period in the media the progesterone level appeared to be elevated. Two months later in the tissue culture numerous transformed cells could be seen and the progesterone level of the media was low. It is believed that alteration of the biosynthesis of progesterone may have a role in the increased production of testosterone and in virilization.

[Rapid determination of antibiotics resistance in clinico-surgical practice on the basis of radioactive carbon dioxide measurements]. / Schnellbestimmung der Antibiotikum-Resistenz in der chirurgisch-klinischen Praxis auf Grund der Messung von radioaktivem Kohlendioxyd.

The radiometric method is founded on the measurement of the 14CO2 which has gone free. This method was worked out of our team. It is a prompt sensitive and quantitative procedure for the control of antibiotic effect on bacteria. The method is a support in critical clinical situations. The prompt establishment of the antibiotic sensitivity can be live-saving. The empirics descended from 312 surgical patients. The antibiotical sensitivity of secretion samples is to be obtained within 4-6 hours. The results show in comparison with the classic bacteriological examinations five per cent less deviation. At the same time the computer analysis enables a finer distinction. 22 variable findings are possible within the categories: sensible, middling sensible and resistant. In that way the tested antibiotics are classified in an order of rank. The apparatus for the examination is producible without particular expenses. The measurements can be carried out at each hospital or clinical laboratory.

[Changes in the Na+, K+, and Ca++ concentrations in the urine in the course of surgical interventions]. / Anderungen der Na+-, K+- und Ca++- Konzentration im Harn im Laufe von chirurgischen Eingriffen.

The tests were carried out on 27 surgical patients. Diuresis and the Na, K and Ca concentrations in the urine were measured before, during and after operation. Due to operational stress and to the drugs used for general anaesthesia diuresis decreases progressively during operation and compared to the conscious state the amount of cations excreted during operations is significantly lower. Decrease of the serum potassium and calcium levels is not explained with the quantity of ions excreted with the urine.

[Changes in kidney function in abdominoperineal rectum excision under halothane anesthesia]. / Anderungen der Nierenfunktion bei abdominoperinealer Rektumexstirpation in Halothan-Narkose.

In 17 cases of abdomino-perineal rectum extirpation performed under combined intratracheal halothane anaesthesia, the volume of urine and the osmolality of serum and urine were determined. Though urinary volume decreased significantly, its osmolality did not rise. According to the operational stress this type of operation can be divided into an: 1) intra-abdominal and a 2) perineal phase. In the secretory and concentrating capacity of the kidney, again two phases can be distinguished. Owing to the great operational stress patients with deficient renal function often develop renal failure. It is stressed that such patients close observation, careful hydration prior to operation and the administration of diuretics are of particular importance.

The effect of surgery on carbohydrate metabolism. II. Insulin response during surgery.

Serum-immunoreactive insulin response on glucose load was observed during the operation of 13 patients. The tests were performed on the same patients also 5 days prior to operation. The patients were divided into two groups according to the performed operation which was either intra- or extraperitoneal. Glucose tolerance during operation remained unchanged, but the serum insulin level was considerably lower. A certain difference was detected between intraperitoneal and extraperitoneal operations in this respect, though the trend of the changes was the same. The probable pathomechanism of the lacking insulin secretion on glucose is discussed.

[Ultrastructure and hormone secretion of a tissue culture from an adrenal gland tumor simulating Cushing's syndrome]. / Cushing syndromát okozó mellékvese-tumor szövettenyészetnek finomszerkezete és hormontermelse

Tissue cultures of a surgically removed adrenocortical tumour causing Cushing's syndrome, and tissue cultures from the attached, tumour-free adrenal were studied. There were two cell types characteristic of tumour tissue. The cell type occurring most frequently had pronounced hypertrophied agranular endoplasmic reticulum. A fewer number of lipidrich cells containing many electron-dense granules could also be found. The ratio of cells changed during cultivation. In the 17 days tumour culture, a higher percentage of lipid-rich cells could be observed. In spite of continuous ACTH treatment, the initially high hydrocortisone level decreased, gradually. It may be assumed that the lipid-rich cells are of reduced ability as regards hydrocortisone production.

Changes in the fine structure and function of a hormone-secreting adrenocortical tumour investigated in tissue culture.

Tissue cultures of a surgically removed adrenocortical tumour causing Cushing's syndrome, and tissue cultures from the attached, tumour-free adrenal were studied. There were two cell types characteristic of tumour tissue. The cell type occurring most frequently had pronounced hypertrophied agranular endoplasmic reticulum. A fewer number of lipid-rich cells containing many electron-dense granules could also be found. The ratio of cells changed during cultivation. In the 17 days tumour culture, a higher percentage of lipid-rich cells could be observed. In spite of continuous ACTH treatment, the initially high hydrocortisone level decreased, gradually. It may be assumed that the lipid-rich cells are of reduced ability as regards hydrocortisone production.

Effect of surgery on carbohydrate metabolism.

The effect of surgery on carbohydrate metabolism has been studied in 20 patients. The blood sugar and serum immunoreactive insulin (IRI) levels were determined during various operations. The blood sugar level rose progressively with the duration of the intervention. A difference was detected in the changes of the blood sugar and serum-IRI levels during extra- and intraperitoneal operations. In the first case the rise in blood sugar and serum IRI was slighter and showed no close correlation with time. During intraperitoneal operations, no corresponding insulin response accompanied the increased blood sugar level.

Changes in blood coagulation due to pancreas transplantation in dogs.

Blood coagulation was studied in the course of 11 pancreatectomies and 7 pancreas transplantations. Comparison of the postoperative changes in the fibrinogen level suggests the important role of the normal pancreas in fibrinogen generation. Investigation of the indices of the coagulation and fibrinolytic system revealed in the post-transplantation period a shift in the activity of the coagulation indices towards hypercoagulability. The increased fibrinogen level, the inhibited fibrinolysis and the elevated activity of the coagulation factors are assumed to be responsible for the high incidence of thrombotic complications associated with transplantation of the pancreas.