Acute gastric dilatation causing respiratory failure and "tension pneumothorax" in an elderly women with a diaphragmatic hernia

The occurrence of respiratory failure as a result of a large diaphragmatic hernia is a well-described entity in infants with congenital hernias. On reviewing the literature, the authors did not find a similar clinical presentation in the adult population. They report the case of an elderly patient with a large hiatus hernia who developed recurrent episodes of life-threatening respiratory failure and hemodynamic compromise due to recurrent gastric dilatation. Decompression with nasogastric suction resulted in dramatic and immediate relief of the respiratory distress. One should keep in mind the possibility of intrathoracic gastric dilatation as a cause of acute respiratory insufficiency in patients with hiatal hernia.

Influence of drugs and ionic gradients on gastric secretory epithelium in vitro

The first part of the paper is devoted to the description of the data acquisition system for studies on epithelial membranes using a process-control computer ECAROM connected to the usual two half-chambers device for epithelial transport studies in vitro. The second part presented the results obtained in several types of experiments concerning the effect of drugs (histamine, acetazolamide) and ionic gradients (K+, Cl-, H+) on the potential difference and/or acid secretion rate.

Theoretical investigations on the role of steroid-skeleton C4 = C5 unsaturation in competitive aromatase inhibition

A quantitative structure-activity relationship (QSAR) approach by use of the minimal topological difference (MTD) method including 46 derivatives of 4-androstene-3,17-dione and 5 alpha-androstane-3,17-dione is applied to give indications about the role of the C4 = C5 double bond in competitive inhibition of human placental aromatase and about sterical requirements in steroid-aromatase interactions. The inhibitory activity is found to correlate with the sterical MTD variable, hydrophobicity, and pi-system conjugation in the A,B-ring region. A comparison of the MTD results reveals a good agreement with interpretations based on free-energy data derived from inhibition constants. By means of MM2 molecular mechanics and PCILO quantum-chemical calculations, the 4-ene structure is shown to significantly influence conformational features of C19 substituents which are important in enzymatic transformations. While 19-hydroxy-5 alpha-androstane-3,17-dione favour a conformation having the hydroxyl group in the enzyme-directed out-of-ring position, the C4 = C5 double bond energetically enables the steroid to adopt a conformation which can be hydroxylated without internal rotations. According to present theoretical findings, the 4-ene unsaturation thus exerts an indirect conformational influence by hydroxyl positioning appropriate to aromatase interactions and a direct electronic influence by pi conjugation.

MTD calculations on quantitative structure-activity relationships of steroids binding to the progesterone receptor

The minimal topological difference (MTD) method is used to describe quantitative structure-activity relationships (QSAR) for the progesterone-receptor binding affinity including 59 progestational steroids. Multiple correlation coefficients of r = 0.962 and r = 0.955 are obtained by use of the MTD variable and a measure of hydrophobicity for the series of progesterone and ethisterone derivatives, respectively. Hydrophobic effects are found to strongly influence receptor binding. In accordance with the hydrogen bonding concept, the optimized MTD receptor maps indicate cavity vertices in the regions of oxygen functions at C3 and in the 17 beta position. Receptor wall vertices are attributed in the areas of 4, 10 beta, and 13 beta substituents of 4-en-3-one steroids while 17 alpha side chains additionally contain receptor cavity vertices. A comparison of corresponding receptor maps suggests in accord with X-ray crystal structure data that progesterone and ethisterone derivatives are bound in somewhat different orientations relative to the receptor surface.

HLA antigens, jejunal morphology and associated diseases in children with dermatitis herpetiformis

Forty-five Hungarian and Finnish children from 1.5 to 15 years with dermatitis herpetiformis were studied for HLA antigens, jejunal morphology on gluten-containing diet and associated diseases in the patients and their relatives. A strong association with HLA-B8 was found in patients of both nationalities, the relative risks were 12.8 and 9.6, respectively. The Hungarian patients were also typed for HLA-DR locus, and an association with DR3 but not with DR7 was observed. Patients with subtotal villous atrophy had slightly more often HLA-B8 and DR3 than those with milder intestinal lesions. Atopic eczema occurred in 20% of the patients and family history of atopy seemed to have an inverse correlation with HLA-B8 and DR3.

Electrical stimulation of the bladder and gravidity

Following experimental investigations, the authors have performed bladder stimulator implantation for paralyzed bladder patients since 1969. Up to 1983 altogether 32 operations were carried out for bladder paralysis following 21 peripheral and 11 central neural lesions. The patients urinated without residue after the operation. The observations showed that regular use of the stimulator led to the elimination of reflux in patients who had vesicoureteral reflux before the operation. It was found that, if the stimulator had to be removed for any reason after a period of 1 or 2 years, the urinating ability was maintained. Of the 7 female patients operated, 2 became pregnant. During pregnancy and delivery, the patients did not experience any problem with the implanted stimulator, and the children were born healthy and at term.

MTD approach to quantitative structure-activity relationships for cardiotonic steroids

A minimal topological difference (MTD) approach is made to describe quantitative structure-activity relationships (QSAR) for the Na+, K+-ATPase inhibitory activity of cardiotonic steroids. The calculations take into account 20 derivatives of digitoxigenin, digoxigenin, and gitoxigenin with small substituents at different sites of the steroid backbone. A multiple correlation coefficient of r = 0.916 is obtained using the MTD and an indicator variable for the presence of a 15 beta substituent. The corresponding receptor map reveals receptor wall vertices in the C11, C12, C15, and C22 regions. Both 3 beta and 16 beta substituents are found to contain receptor cavity vertices. The MTD results are discussed with respect to lactone-ring conformational investigations presented and they are compared with findings of previous structure-activity studies.

QSAR application in chemical carcinogenesis. II. QSAR analysis of a class of carcinogenesis inhibitor: retinoids

Quantitative structure-activity relationships for the reversion of keratinization of hamster tracheal cell organ culture by structurally related retinoids were formulated. Their biological activities (ED50 . M) were correlated with the following parameters: the minimal topological difference (describing the fit of the considered molecules with a possible receptor site) and the lipophilicity constants. For computation purposes the retinoids were divided in three series (A, B and C) according to structural modifications in the cyclic moiety of the molecule, in the polienic chain and in the terminal functional group, respectively. The computed regression equations suggested the importance of the stereochemical features of cyclic moiety (for series A, eq. 1, n = 19, r = 0.926, F = 48.19) and of the uninterrupted conjugation for the polienic chain (for series B, eq. 6, n = 11, r = 0.954, F = 39.39) for the biological activity. In order to check the prediction potential of the regression equation computed for the overall set of compounds (eq. 10, n = 53, r = 0.853, F = 32.11), it was used to calculate the ED50 for a test series of 15 retinoids. The correlation obtained between ED50 exp and ED50 calc for this series was r = 0.916, F = 60.25. The nature of the receptor site possibly involved in the interaction with retinoids was discussed.

[Recurrence prevention of papillomas of the bladder using lycurim instillation]

Following surgical removal of papillary tumours of the bladder from 60 patients the authors performed short instillations of the bladder with LYCURIM. The histological picture revealed tumours in the stage O-A-B1 and grade I-II-III. In a control group (n = 129) 89 recidive cases were observed in 2 years. Out of the 60 patients of the LYCURIM group 19 (31.7%) were free of tumours for 2 years and 43 (71.7%) for 11/2 years. A transient cystitis which occurred with short application of the medicament was easily cured. Toxic effects on the blood picture were not observed.

[Importance of a persisting left vena cava superior in pacemaker therapy (author's transl)]

Basing on the description of a specific case and a review of literature, the article discusses the relationship between persisting left ven cava superior and pacemaker therapy. The article covers the technical problems caused by the vascular anomaly, the complications which can be expected, the possibilities in respect of recognising the vascular anomaly, as well as the methods for coping with the special situation prevailing in a particular case.

[Analysis of histochemical changes caused by acute Wofatox poisoning in a model experiment]

Effect of Wofatox on the central nervous system, striated muscles and on the myocardium of rats has been studied by the aid of light- and electron microscopic histochemistry. A single intraperitoneal injection of LD50 of Wofatox resulted in a total inhibition of the activity of histochemically demonstrable acetyl-cholinesterase in the central nervous system. Each striated muscle fiber has shown different sensitivity to the inhibitor, but enzyme activity of end motor plates could not be totally inhibited. In lethal acute intoxication ultrastructural changes of the myocardiuim have shown characteristic features of cardiomyopathy.

Quantitative structure-activity relationships in erythromycin group with MTD technique

Quantitative structure-activity correlation studies were performed for a group of 17 erythromycin derivatives modified in the C-8--C-12 portion of the molecule. The minimal steric difference, MTD, was used as the structural parameter and logarithm of the biological potency measured by a standard assay, as the biological parameter. The influence of the sp2 hybridization at C-9 and of the presence of 11, 12-carbonate grouping on the antibacterial activity was shown. The reported results give a further support to our hypothesis on greater complementarity of the cyclic 11, 12-carbonates in the reaction on the bacterial ribosomes in comparison with their parent antibiotics.

[Radiographic changes following transurethral cryocaustic surgery of the prostate gland (author's transl)]

Presentation of the cryocaustic procedure and its radiographic features on the postoperative urethrogram. For correct interpretation, a preoperative study is important.

Minimal steric difference study of structural requirements for the luteinizing hormone-releasing hormone (LH-RH) receptor

Quantitative structure-activity relation for amino acid substitution analogues of the LH-RH decapeptide were established by means of the receptor site mapping procedure based upon minimal steric differences. For a series of 17 analogues of LH-RH, obtained by substitutions of the C-terminal Gly-NH2 residue, a corelation coefficient r = 0.93 was obtained, for a series of 7 analogues, obtained by substitutions of the Leu7 residue, r = 0.95 was obtained. The shape of the LH-RH receptor regions interacting with the C-terminal of the decapetide and with the Leu7-side chain is inferred from this study.