Diclofenac-induced cytotoxicity in cultured carp leukocytes.

Diclofenac is a drug commonly used in human and veterinary medicine for the treatment of diseases associated with inflammation and pain. Medicinal products enter waste and surface waters on an everyday basis and contaminate the aquatic environment. Fish are therefore permanently exposed to these chemicals dissolved in their aquatic environment. To simulate variable environmental conditions, the aim of our study was to examine adverse effects of diclofenac under different temperatures of cell incubation (18, 21, 24, 27 and 30 °C). Cyto-toxic and -static effects of diclofenac in concentrations of 0.001 mcg/ml, 0.01 microg/ml, 0.1 mcg/ml, 1 mcg/ml, 10 mcg/ml and 100 mcg/ml for the carp (Cyprinuscarpio) cultured leukocytes were quantified using detection of lactate dehydrogenase released from damaged cells. Overall DCF cytotoxicity was relatively low and its impact was pronounced at higher temperature and DCF concentration. Cells growth inhibition is changing more rapidly but it is high mainly at the highest concentration from low temperature. DNA fragmentation was not detected in tested leukocyte cell line. CYP450 increased diclofenac cytotoxicity only at the highest concentration but at incubation temperatures 18 and 27 °C. Leukocyte viability is essential for immune functions and any change can lead to reduction of resistance against pathogens, mainly in cold year seasons, when the immune system is naturally suppressed.

Hepatic perfusion changes in patients with cirrhosis indices of hepatic arterial blood flow.

PURPOSE: This study used radionuclide angiography to evaluate semiquantitatively the hepatic arterial blood flow changes associated with cirrhosis. METHODS: The parameters of net arterial hepatic perfusion were estimated by analysis of first-pass flow studies in 11 control participants and in 15 patients with cirrhosis (Child-Pugh classification B-C). Hepatic, renal, and splenic time-activity curves were generated, normalized per pixel, and corrected for background. The rate of hepatic arterial blood flow was compared with the reference kidney and spleen perfusion using the hepatorenal and hepatolienal perfusion indices, respectively. These indices were defined as: PI = area under hepatic curve limited by time of the renal (splenic) curve peak/area under renal (splenic) curve to its peak RESULTS: The values of both these perfusion indices are significantly greater in the patients with cirrhosis than in controls (hepatorenal perfusion index, P < 0.01; hepatolienal perfusion index, P < 0.05). The values of the hepatic perfusion index (the ratio of the arterial to the total liver blood flow), which were also calculated, were elevated in the patients with cirrhosis (P < 0.01). CONCLUSIONS: The results confirm that the net hepatic arterial blood flow is increased in patients with cirrhosis. Radionuclide angiography accompanied by calculation of arterial perfusion indices may provide semiquantitative parameters of net hepatic arterial blood flow.

[Life prognosis in patients with prehepatic portal hypertension treated with portosystemic shunts]. / Zivotní vyhlídky nemocných s prehepatickou portální hypertenzí, lécených portosystemickou spojkou.

The authors present the results of the long-term follow up of nine patients with prehepatic portal hypertension treated by a portosystemic anastomosis. The evaluation was made 5-21 years after operation, according to criteria focused on the therapeutic effect of the anastomosis and its possible pathophysiological sequelae. In the authors' opinion the anastomosis is the operation of choice suited for patients lacking a tendency of normalization of the portal circulation and with dangerous manifestations of portal overpressure. The indication is restricted to early age of the patients (for technical reasons). Conversely the patient should not attain adult age without unresolved hypertension. For correct timing of the operation knowledge of the development of the disease is essential. Primarily infact livers do not undergo pathological changes even after years of hypertension nor several years after an anastomosis. This is consistent with the fact that these patients lack clinical manifestations of portosystemic encephalopathy. Investigations of the course of flow curves during semiquantitative evaluation of hepatobiliary sequential scintigraphy supported the previous view that establishment of the anastomosis and elimination of portal overpressure improves hepatic perfusion. Hepatobiliary sequential scintigraphy not previously used in this indication may be of value in the follow up of the disease and evidence of the anastomosis. This preliminary conclusion is being tested in a prospective study.

[Traumatic chylothorax and chyloperitoneum]. / Traumatický chylotorax a chyloperitoneum.

Traumatic chylothorax and chyloperitoneum are rare. Effusion of the chyle into the pleural cavity occurs after severe injuries of the chest wall after pretentious surgical operation in the posterior mediastinum and after operations of the cardiovascular system. The authors recorded one observation after operation of a patent ductus arteriosus and controlled the situation by a conservative procedure. A traumatic chyloperitoneum develops typically after a minor or obscure injury. The pathological picture usually develops slowly, in rare instances it imitates an acute abdomen. The condition calls for laparotomy. Only in rare instances a fissure is detected in the posterior peritoneum and it is very difficult to detect the sites of injuries of lymphatic vessels. The authors treated three patients. All were operated, two were subjected to laparotomy twice. A relapsing chyloperitoneum was brought under control by hitherto non published surgical procedures: in one instance by communication of the abdomen with the posterior mediastinum, in the second case by ligature of the lymphatic vessels close to the vasa mesenterica cran. All patients recovered.

[Obliterative disease of the carotid and peripheral arteries in hyperlipoproteinemia]. / Obliterující nemoc karotických a koncetinových tepen u hyperlipoproteinémií.

The authors give an account of changes of the carotid and peripheral arteries detected by ultrasonic examination in a group of 133 patients with different forms of primary hyperlipoproteinaemias. Stenoses in the extracranial carotid circulation were found in 31% of the group, stenoses of the peripheral arteries in 37%; in 18% combined changes of the carotid and peripheral system were found. The authors proved a rising trend of the number of risk factors with the rising number of arterial stenoses. The most frequent risk factors were obesity and smoking. In the entire group changes of the peripheral arterial system were found in more than half the patients (in 53%); in clinically asymptomatic subjects they were proved in 39%. The authors emphasize the necessity to introduce ultrasonic screening of the arterial system in all patients with hyperlipoproteinaemia.

Importance of spectral analysis indices for assessment of the grade of stenosis of the arteria carotis interna.

The authors evaluated the indices of Doppler power frequency spectrum analysis in 106 patients with suspected extracranial carotid occlusive disease. Blackshear, Norrving and Knox indices appeared to be most sensitive for identification of the grade of stenosis of the arteria carotis interna. Sensitivity of ultrasound examination was correlated with angiography. The highest sensitivity (90%), specificity (100%), and overal accuracy (97%) were recorded in the group of hemodynamic significances disturbances of ACI, i.e. high stenoses with occlusions. Calculation of indices of spectral analysis has been performed routinely in all non-invasive ultrasound examinations of carotid arteries by means of Echoflow method.

Radionuclide hepatic perfusion index and ultrasonography: assessment of portal hypertension in clinical practice.

The final value of portal blood flow pressure depends on the degree of vascular obstruction, then on the resistance in collateral vessels and, last, on splanchnic blood flow. The iniciating cause of portal hypertension most often lies in advancing anatomical damage leading to increased resistance and, consequently, to a reduction of portal blood flow, and simultaneous reciprocal development of extrahepatic collaterals. The determination of a true portal flow is a necessity particularly when deciding about a shunt surgery and its type, but it also supplies valuable information on the degree of portal flow restriction and, in this way, on the progress of pathophysiological changes, their extent and advance. The technique of radionuclide angiography and determination of the hepatic perfusion index (HPI) proposed by Sarper appears to be a profitable noninvasive method supplying well reproducible information on portal blood flow. Sarper proved it to be correlated with the degree of portal hypertension established by angiography. Ultrasonographic criteria of portal hypertension include dilatation of the portal vein in the region of the hilus hepatis exceeding 15 mm, and a more than 10 mm dilatation of the splenic vein above the spine. The mean HPI value obtained from the examination of 19 subjects without liver involvement was 0.6956 +/- 0.0583. The group of chronic hepatopathies included 19 patients with bioptically verified chronic hepatitis without reconstruction and/or steatosis, and 32 patients with liver cirrhosis likewise confirmed by biopsy: portosystemic shunts could be demonstrated in 14 of the latter. (ABSTRACT TRUNCATED AT 250 WORDS)

Results of immunosuppressive treatment: Prognosis in chronic active hepatitis.

A series of 21 patients with active chronic hepatit diagnosed on the basis of clinical, biochemical and histological criteria, were treated by immunosuppressive cure--a combination of Prednison or Triamcinolon with 6-Mercaptopurin. The cure lasted for at least 12 months and attempts as its interruption usually brought about exacerbation of activity requiring further treatment reaching the total of more than 3 years, in some cases lasting for all the followed period of 7 years. There were no significant side effects requiring interruption. Immunosuppressive treatment remarkably improved biochemical indicators, particularly significant was the decrease in SGPT activity and hypergammaglobulinemia. The results were likewise good in HB-Ag positive patients, 8 of which are included in the series. The prognosis of chronic active hepatitis undergoing immunosuppressive treatment was mathematically estimated. Using the mathematical solution of biological problems the authors arrived at the probable survival of 5.5 to 6.5 years for their series of patients.