[The place of enalapril in the management of hypertension]. / Az enalapril helye a magasvérnyomás-betegség kezelésében.

In Hungary the use of angiotensin converting enzyme inhibitor enalapril has emerged as one of the most important drugs in the treatment of hypertension. The aim of our study was to evaluate the antihypertensive effect of enalapril of Hungarian production in combination therapy and alone, according to sexes, to the body mass index, among smokers and non smokers as well as non diabetic and in patients with diabetes (IDDM and NIDDM). The diurnal blood pressure values were registered by a 24 hour ambulatory blood pressure monitor. During the 6 weeks of the enalapril therapy (n = 28) both the daytime (141/84 vs. 135/80 mmHg) and the night-time (130/78 vs. 124/72 mmHg) blood pressure values decreased; the increase of diurnal indices during the therapy (SI/DI 6/8% vs. 8/10) reflect the 24 hour long lasting effect of the drug. The body mass index had no influence on the efficacy of treatment. Our results indicate that enalapril manufactured in Hungary is an effective antihypertensive drug both in monotherapy and in combination, in both sexes (especially in men), irrespective of the body weight, in non-smokers and especially in smokers, in insulin dependent and in non-insulin dependent diabetes mellitus alike.

Altered ovarian progesterone secretion induced by cadmium fails to interfere with embryo transport in the oviduct of the rat.

The effect of Cadmium (Cd) on embryo transport through the oviduct and on ovarian progesterone (P) secretion were studied in the rat. Animals were given 2.5, 5, 10 mg/kg CdCl2 or 1.0 mL/kg NaCl sc on day 1 of pregnancy. On days 1, 2, 3, 4, and 5, they were anesthetized with pentobarbital, cannulae were inserted in one of the utero-ovarian veins, and 5-minute blood samples were taken from the ovary. Ovarian venous outflow was recorded, P was determined from the blood fractions, and secretion rates were calculated. P levels were determined in peripheral blood. Body weights and the wet weight of adrenals, ovaries, and oviducts were checked; oviducts and uterine horns were flushed; and number, location, and developmental stage of embryos were observed. Cd content of the oviducts was measured. Cd accumulated dose and time dependently in oviducts and induced a dose-dependent depression and delay in the rise of ovarian P secretion during days 1 through 5 of pregnancy. In the peripheral blood, P levels also failed to rise until day 4 of pregnancy in Cd-treated rats. In embryo transfer, however, no alteration could be observed. It is hypothesized that lack of vascular contact in the oviduct makes it possible for the preimplantation embryos to escape toxic effects of Cd.

Endocrine consequences of danazol treatment in menorrhagia.

In order to study the endocrine side-effects of danazol, 15 patients with severe, benign menorrhagias, were individually treated with this drug to stop bleeding. LH, FSH, testosterone, free testosterone, DES-S, androstenedione, prolactin, estradiol and cortisol serum concentrations were measured before and after the 3 month treatment period. Danazol was found to be effective in reducing the amount of bleeding in patients with benign, severe menorrhagias; however, the weight gain of patients was significant during the 3 month period. LH and estradiol concentrations decreased; testosterone, free testosterone and dehydroepiandrosterone sulfate increased; prolactin, FSH, androstenedione and cortisol serum concentrations did not change, and SHBG disappeared from the serum, during the treatment period. We are of the opinion that danazol is an effective drug in menorrhagias with side-effects. In our view the hyperandrogenicity is the most important side-effect of this substance, which might be the result of some metabolites, but which might be the effect of a peripheral action of the drug as well.

Episodic secretion of hormones and the diagnostic value of single blood estimates. III. Testosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulphate, cortisol.

The episodic fluctuation of serum testosterone, androstenedione, dehydroepiandrosterone (DHA), dehydroepiandrosterone sulphate (DHAS) and cortisol levels was analysed to determine the reliability of a single blood estimate in characterizing the mean value of a 4 h period. Radioimmunoassay of the steroids was performed in sera of 8 apparently healthy women in various phases of the menstrual cycle in 10 min intervals between 08 and 12 h a.m. Reliability criteria of the methods used were comparable to those in common use. The within-person fluctuation of individual values was determined by the coefficient of variation of single estimates, and the methodological error of the single estimates was characterized with the maximum increment from the mean at 95% confidential limits. A maximum deviation of 30.8, 28.6, 37.0, 25.0 and 61.2%, respectively, found in the above order of steroids, suggests several hormone estimations to be necessary for judging hormone availability in a subject.

Episodic secretion of hormones and the diagnostic value of single blood estimates. II. Progesterone, oestradiol and oestrone.

The episodic fluctuation of serum progesterone, oestradiol and oestrone levels was studied. Progesterone was determined in the luteal phase, oestradiol and oestrone concentrations were measured in the proliferative and luteal phases in 8 subjects in 10 min intervals between 08 and 12 h a.m. Reliability criteria proved the radioimmunological methods used to be comparable to those employed routinely. The within-person fluctuation of hormone levels characterized by the coefficient of variation of single estimates averaged 20.16, 23.0 and 11.6% for progesterone, oestradiol and oestrone, respectively. The considerable fluctuation of hormone concentrations suggest the importance of hormone measurements to control luteal function and folliculogenesis during the menstrual cycle.

Episodic secretion of hormones and the diagnostic value of single blood estimates. I. LH, FSH, prolactin.

The episode fluctuation of serum LH, FSH and prolactin levels in peripheral blood was studied to determine the reliability of single estimates of the average blood level. Radioimmunoassay of the hormones was performed in serum withdrawn every 10 min between 8 and 12 h a.m. from 8 healthy women in various periods of the menstrual cycle. The rate of fluctuation of the hormone levels was characterized by the within-person coefficient of variation of single estimates, which averaged 30.3, 15.1 and 19.2% for LH, FSH and prolactin, respectively. Due to a pronounced fluctuation of gonadotropin levels, analysis of several serum samples is recommended to approach the actual mean hormone level.