[Possibility of early diagnosis of diabetic nephropathies]. / Cukorbetegek nephropathiájának koraibb kórismézési lehetösége.

The serum and urine level of beta-2-microglobulin was examined by the authors in different stages of nephropathy of 250 patients suffering from diabetes mellitus (I type 178 pts, II type 72 pts). Beta-2-microglobulin values measured in diabetic patients without renal microangiopathy did not show any difference compared with that of the controls. In patients with freshly discovered diabetes mellitus significantly decreased beta-2-microglobulin levels were found, probably due to the increased glomerular filtration rate. Increasing beta-2-microglobulin values indicating an early glomerular lesion--were observed in incipient diabetic nephropathy. These values were significantly higher compared with that of healthy individuals and diabetic patients without renal microangiopathy. In the IV stage of disease the serum and urine beta-2-microglobulin levels were equally found to be elevated, indicating an impaired function of proximal tubuli beside the vascular lesions. The most expressed beta-2-microglobulin value elevations were observed in the stage of nephropathy. The authors emphasize the importance of determination and common evaluation of 24 hours protein excretion and serum urine beta-2-microglobulin values the earliest diagnosis of incipient renal lesion. According to their results, the introduction of this method may be very useful for early indication and follow-up of specific renal complications in diabetes mellitus patients.

[Arterial occlusion in the ocular fundus induced by oral contraceptives]. / Oralis anticoncipiens szedése során kialakult szemfenéki arteriás occlusio.

PIP: To counter the paucity of documention on thromboembolic disorders caused by oral contraceptives (OC), a case study is presented describing the incidence of occlusion of arteria centralis retinae in a 24-year old woman after prolonged use of an OC, Bisecurin. She had taken Bisecurin for 4.5 years and had gained 20 kg during that time, but stopped usage 1 month before admission. She was hospitalized with severe deterioration of vision in the left eye. An eye examination indicated an edematous condition of the retina and reddening of the macula. Acuity of vision value for the left eye was .01 vs. 1.0 for the right, which was confirmed by fluorescein fundus angiography. Moderately decreased antithrombin III (AT III) activity was also ascertained. Treatment consisted of immediate retrobulbar injection with Tolazolin followed by Rheomacrodex, Cavinton infusions, B1 and B12 injections, Oradexon subconjunctival injection as well as vitamin B complex, Cavinton, and Colfarit tablets and a fat-free diet. Significant improvement of the left eye condition appeared 4 weeks later. Periodic follow-ups showed the healing of the condition around the macula; however, the patient suffered permanent damage to the retina due to the arterial occlusion above and below the macula. The disturbed lipid values of metabolism were also returned to normal, as borne out by normal dextrose loading results 8 months later (glucose tolerance was abnormal during examination at admission). The estrogen and progesterone components of OCs have been shown to reduce AT III levels, shorten heparin-thrombin coagulation time, increase fibrinogen levels, decrease HDL cholesterol levels, and produce excess TXA2 (thromboxan) resulting in vasoconstriction and thrombocyte aggregation. The risk of thrombosis is 6 times higher in OC users than in nonusers, although other susceptibility factors (obesity, diabetes, hypertension) also contribute to thrombosis.^ieng

Fluoroangiographic picture of the acute stage of the retinal lesion in subacute sclerosing panencephalitis.

The fluoroangiographic examination of the acute stage of retinal lesion in a 16-year-old girl suffering from SSPE showed an exclusively localized retinal vascular involvement 4 days after the onset of her visual complaints. A week later this occlusive vascular lesion progressed to a large area of capillary bed obstruction and it was followed up angiographically. The choroid was involved even during the late stages of evolution of retinal lesion at a low degree. Our angiographic findings enable us to consider a neuroretinal location of primary pathological process in the retina.

[Binocular inferior altitudinal hemianopia following occult hemorrhage (author's transl)]. / Bilateraler Ausfall der unteren Gesichtsfeldhälfte als Folge okkulter Blutung

Authors report a case of binocular inferior altitudinal hemianopia caused by occult haemorrhage from the gastrointestinal tract. There was a 36 hours' period between the onset of visual field defects of the two eyes. The ocular signs have thrown light on the grave anaemic condition. The internal state of the patient was rapidly improving but the visual field defects have remained the same.