[Experiences with determination of cardiac Troponin-I and CK-MB serum levels in acute coronary syndrome]. / Tapasztalataink a kardiális Troponin I és CK-MB tömeg-meghatározással akut coronaria-szindrómában.

The consideration of the correct diagnosis and prognosis in acute coronary syndrome seems to be a great challenge for cardiologists. Measuring of the serum cardiac Troponin (cTI) level may help solution of this problem. According to the authors the myocardial infarction has been revealed with a great sensitivity and specificity by the cTI level (100%). Authors found a higher level of cTI even after 72 hours of the onset of symptoms of myocardial infarction. After thrombolysis the wash out phenomen was more expressive compared with the values of CK-MB enzymes. A moderate but significant increase was observed of the cTI level in unstable angina. The measuring of cTI in acute coronary syndrome gives an important information to the correct diagnosis. The prognostic considerations of cTI level in unstable angina are interpreted by authors according to relevant data of literature.

Application of pressurized sample preparation methods for the analysis of steels and copper alloys.

Pressurized sample preparation devices (High Pressure Asher, Pressurized Microwave Digestion system, compared with a PTFE decomposition vessel) were used to dissolve certified metal alloy samples (steel, copper) for ICP analysis. Based on the results of the analysis it was established that both up-to-date devices can be advantageously applied to quickly and quantitatively dissolve metal alloy samples. To dissolve the samples, two different kinds of acid mixtures (A: nitric and hydrochloric acid; B: nitric and hydrochloric and sulphuric and phosphoric acid) were used. The sample preparation is simpler and less time-consuming than the earlier commonly used methods, sample loss and degree of contamination are also reduced. Steel samples containing tungsten, titanium and niobium (less than 0.5%) can only be analyzed using a mixture of the four acids. By dissolving steel samples in the nitric and hydrochloric acid mixture, the concentration of their most common elements (Cr, Ni, Mn, V, Cu) as well as their S and P content can be determined. Copper alloy samples can be dissolved quickly by the pressurized microwave decomposition device using hydrochloric acid and diluted (1:1) nitric acid.

Diabetes mellitus associated with late onset congenital adrenal hyperplasia: coincidence or causality?

Diabetes mellitus and late onset congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency were observed in two female siblings aged 51 and 60 years. Not only coincidence but also causality (hyperinsulinism, glucose intolerance due to hyperandrogenism) should be considered when explaining the association of diabetes mellitus with late onset congenital adrenal hyperplasia.

The turnover of autophagic vacuoles: evaluation by quantitative electron microscopy.

Accumulation of autophagic vacuoles was induced in mouse liver, exocrine pancreas and seminal vesicle cells by intraperitoneal injection of vinblastine, leupeptin, Triton X100 or estron acetate and the turnover of the autophagic vacuole content was estimated by morphometry from the time course of regression of autophagic vacuoles following the administration of cycloheximide to the animals. The volume fractions of autophagic vacuoles increased manifold following the administration of any of the drugs in each cell type investigated. The autophagic vacuoles regressed rapidly after administration of cycloheximide to the animals pretreated with Triton X100, estron acetate and leupeptin and the decay appeared to follow first-order kinetics; the estimated half life of autophagic vacuoles was about 6-9 min. Regression of autophagic vacuoles was very slow (apparent half life 30 min or longer) in mice, pretreated with vinblastine, indicating the inhibitory action of this drug on the turnover of autophagic vacuoles in vivo.

Hepatic artery embolisation--new approach for treatment of malignant carcinoid syndrome.

A transcatheter embolisation was carried out for treatment of a patient suffering from hepatic metastases of a malignant carcinoid tumour. Recurrent and very severe carcinoid symptoms could be observed; a bronchial carcinoid supposingly the primary tumour without characteristic symptoms was removed six years before. The carcinoid symptoms became resistant to pharmacological agents and finally ended in life-threatening clinical complications. The transcatheter hepatic artery embolisation was successfully performed and repeated three months later. After embolisation relief of carcinoid symptom and a significant decrease in 5-hydroxyindole acetic acid (5-HIAA) urinary excretion lasting for eight months could be observed. There were no serious complications with adequate pharmacological cover, however, a transient fever, leucocytosis, abdominal pain and an increase in serum transaminase activities occurred after the procedure. The transcatheter hepatic artery embolisation should be a method of choice for treatment of patients with carcinoid metastases producing severe carcinoid symptoms resistant to pharmacological agents.

The effect of experimentally induced myocardial ischemia on the norepinephrine metabolism of the dog heart.

Myocardial ischemia is known to provoke an excess in circulating norepinephrine and thus be related to an increased irritability of the heart. In the present experiments, we studied the norepinephrine and potassium content, oxygen tension, and pH values of the effluent of coronary sinus after thoracotomy and catheter placement into the coronary sinus. Once a steady state was reached, the measurements were repeated in the fifth, tenth, 20th, and 60th minutes of experimental myocardial ischemia provoked by coronary ligation of the left anterior descending coronary artery. The parameters obtained were compared to the corresponding values measured in the peripheral vessels. The results indicate an increased release and probably an increased turnover of norepinephrine in the ischemic myocardium. The role of metabolism acidosis in the changes in norepinephrine metabolism was suggested. It is assumed that intracellular acidosis is involved in the enhanced accumulation and release of norepinephrine in the damaged myocardium and that an increase of norepinephrine concentration in the myocardium may be considered a risk factor in supporting heart function.

Myocardial noradrenaline uptake after coronary occlusion in the rat.

Coronary ligation produced a marked increase in labelled noradrenaline uptake by the myocardial tissue of rats. The peri-ischemic zones showed an elevated accumulation of noradrenaline on the 4th day but the intact zone had returned to normal values. At the 14th day of observation, both the ischemic and per-ischemic tissue exhibited a subnormal accumulation of radioactivity. The role of the acidotic state in the changes of noradrenaline uptake was studied in vitro. Noradrenaline accumulation in the myocardial tissue was higher at pH 6.8 than at 7.4 or 7.1 Competition studies revealed that unlabelled noradrenaline had occupied the binding sites in the same quantity at pH 6.8 and at 7.4. It is assumed that intracellular acidosis was involved in the enhanced accumulation of noradrenaline in the damaged myocardium, and that an increase of noradrenaline concentration in the myocardium may be considered a risk factor in supporting heart function.