Psychological sequelae of abdominal stoma and the value of informing the patients and their families

Results of investigations carried out in a 500-person group of patients with stoma and their practical applications are discussed. 1. Despite operational shock, the majority of patients is able to adopt to the new situation and develop different life-style. 2. Rehabilitation facilities pre-operational management and provides an information on stoma before surgery. Postoperative management should consider psychosocial aspects of the stoma. 3. An important role in rehabilitation process play: preparation of the patients' families before the surgery including information on the diagnosis, prognosis and planned therapy. 4. Persons who underwent the same surgery and continue active life may favourably contribute to the postoperational care of patients with stoma. Activity of so-called patients clubs plays also positive role.     

Effect of long-term treatment with guanfacine on selected humoral metabolic indices in patients with primary hypertension

An effect of the treatment with guanfacine on the activity of the adreno-sympathetic system, beta-thromboglobulin, beta-endorphin, and blood lipids was studied in 30 patients with the primary arterial blood hypertension. It was found that guanfacine significantly decreases plasma noradrenaline, adrenaline, and dopamine. Moreover, it decreases the excretion of noradrenaline, adrenaline and 4-hydroxy-3-methoxy-phenylglycol. These effects correlate with the drop in both systolic and diastolic blood pressure. A decrease in plasma renin activity was also observed. It correlated with the blood pressure drops. Guanfacine increased beta-endorphin levels while beta-thromboglobulin, total cholesterol and triglycerides levels remained unaffected. The authors suggest that the hypotensive effect of guanfacine is related to the decrease in adreno-sympathetic system activity and plasma renin activity and no effect on the erythrocyte activity and lipids metabolism.     

Pharmacokinetic disposition of pethidine under tolerance

Under tolerance, evoked by multiple doses of pethidine (PD), the serum and brain tissue content of PD was related to diminished analgesic activity. Even though in tolerant rats no enhancement of PD biotransformation in the liver could be recognized (as followed by the measurement of hepatic esterase and N-demethylase activity), the amounts of both PD and nor-PD excreted in urine were increased under tolerance. The authors conclude that the faster disposition of PD may contribute to the development of tolerance.     

Changes of enzyme activity in the rat liver at different age in circadian cycle

Most of the biological processes in the living organisms of both animals and man are known to be of rhythmical nature. Variability of enzymatic activity in circadian cycle depends on many factors among other on age, sexual maturity, diet as well as medication. The results obtained in our studies indicate, that the activity changes of acid phosphatase and ATP-ase Mg++ dependent in the liver of all the examined age groups were of 24 hour circadian rythm. As to the acid phosphatase activity the results of this experiments showed that in circadian cycle in all examined age groups there is only one peak of elevated activity. ATP-ase Mg++ dependent showed two activity peaks appearing at the same hour both in 30 and 60 days old animals. It should be noticed that the activities of ATP-ase Mg++ dependent in 100 day old animals were two times higher than in 30 and 60 days old rats.     

Mixed pituitary tumours--effects of bromocriptine treatment: Parlodel MR and Parlodel LAR.

Majority of pituitary tumours secrete one of the named hormones: PRL, GH, ACTH, proopiomelanocortine, alpha and beta subunit of TSH, LH, and FSH. Some of those tumours secrete two or more hormones. The aim of this study was to determine the effect of bromocriptine (Parlodel MR and LAR) upon secretion of hormones and tumour size in 10 patients with mixed pituitary tumours. In all patients pituitary and peripheral hormones, CT scan and visual fields were examined before and after treatment with bromocriptine: Parlodel MR and LAR. Bromocriptine treatment decreased PRL secretion in all 10 patients; GH--in all 6 in whom it was increased; TSH--in 2, FSH--in 2 and alpha-subunit in all 6 in whom they were increased. In 5 patients treatment resulted in shrinkage of the tumour mass by 20 to 35%. In all examined subjects clinical improvement was achieved. Our results demonstrate that bromocriptine (Parlodel MR and LAR) is very effective and well tolerated in the treatment of patients with mixed pituitary tumours particularly those with hyperprolactinemia.     

Effect of methylguanidine and guanidine succinic acid on methemoglobin reductase activity in human red cells]

Activity of methemoglobin reductase was studied in human red cells treated with methylguanidine and guanidinosuccinic acid in concentrations similar to those in plasma of patients with chronic renal failure. Enzyme activity was measured with Richterich technique following an incubation at 37 degrees C for three hours. Results have shown that methylguanidine in concentration of 5.4 x 10(-5) mol/l decreases activity of methemoglobin reductase in human red cells on average by 13.9%. Higher concentrations potentiate this effect. Similar changes in methemoglobin reductase activity were noted after introduction of guanidine-succinic acid into the mixture. This agent in concentration 5.6 x 10(-5) mol/l inhibited activity of the tested enzyme by 34.2% on average. Combined methylguanidine in concentration of 5.4 x 10(-5) mol/l and guanidine-succinic acid in concentration of 2.8 x 10(-5) mol/l inhibited methemoglobin reductase activity by 33.0% on average. It may be suggested, that methylguanidine and guanidine-succinic acid being low molecular uremic toxins may significantly decrease methemoglobin reductase activity in red cells of patients with chronic renal failure.     

Differential regulation of the brain and gut immunoreactive dynorphin by the serotonin system

Administration of drugs such as fenfluramine, 20-40 mg/kg, and m-chlorophenylpiperazine (m-CPP), 2.5-5 mg/kg, which release serotonin or activate postsynaptic serotonin receptors, respectively, induced a dramatic decrease in the duodenal content of immunoreactive dynorphin (ir-DYN). The effect was antagonized by cyproheptadine, 1 mg/kg. Similarly, acute administration of the specific serotonin reuptake blockers fluvoxamine, 15 mg/kg, or femoxetine, 10 mg/kg, and 5-hydroxytryptophan (5-HTP), 40-160 mg/kg, evoked a marked decrease in the duodenal content of ir-DYN. A combined administration of fluvoxamine or femoxetine and 5-HTP failed to potentiate the effect of individual treatment. Only a higher dose of fenfluramine, 40 mg/kg, increased the ir-DYN content in the hypothalamus. These results suggest that the brain and gut ir-DYN is independently regulated by the serotonin system and that a serotonin mechanism might stimulate release of the gut dynorphin content.