RESUMEN

The influence of the preparation moniside (isosorbide-5-mononitrate on some functional, lipid and enzymic changes in a model of hyperproteinemia of rats was investigated. Studies were carried out on 45 male rats, divided into 3 groups: I group-control, nontreated; II group--control treated with cholesterol diet; III group--experimental treated with cholesterol diet and monoside in a dose of 20 mg/kg of body weight orally 6 days a week. The experiment continued 3 months. Changes in general state, body mass, static physical endurance, stability to electric current were described as well as the following lipid parameters: cholesterol (mmol/l), cholesterol in lipoproteins with high density (LHD), cholesterol in lipoproteins with low and very low density (LLD, LVLD), tryglycerols (Tr), free fatty acids (FFA). Changes in enzymic activity of aspartataminotransferase (ASAT), alaninamidotransferase (AlAt), hydroxybutiratdehydrogenase (HBDH) and creatinphosphokinase (CPK). Morphological examinations of heart, aorta, liver, kidneys and adrenal were made as well. The results from the experiments showed that in a model with hyperlipoproteinemia general state of experimental animals was impaired, body mass was reduced, physical endurance and stability to electric current reduced, while cholesterol and LVLD/were increased, AlAt increased mult many times, but HBDH and CPK diminished their activity. Functional possibilities of the organism increased at a slight degree under the influence of monoside. Lipid changes, established after cholesterol diet, did not change substantially, while deviations in enzymic activity were normalized.

Asunto(s)

Asunto(s)

RESUMEN

Forty eight cases with infections endocarditis (IE) are analyzed--27 males and 21 females (75% at the age of 31-60). Only in 12.5% IE has developed on intact valvular apparatus. In 83.4% the preceding valvular pathology is rheumatic heart defect (RHD), and congenital cardiac malformations and valvular dysplasia--8.3% each. The mitral-aortic valvular defects predominate in RHD, followed by aortic, tricuspid and mitral ones. In 83.3% X IE is with valvular localization, in 4.2%--parietal and in 12.5%--on valvular prostheses. Vegetations are highly specific for valvular IE (100%) as well as ulcerations (90%) and perforations (45%). Ruptures of extra-valvular structures are established in 8.3%. The inflammatory alterations in myocardium are in 62.5%. The pericardial changes are found in 14.6%, mainly in the cases with valvular prosthesis. Septic changes are established in all cases in the spleen and regeneration of bone marrow, and vascular changes--in 85.4%. The cases with embolism and infarctions predominate in the kidneys (79.1%), followed by the cases with Löhlein's focal nephritis (18.6%). The inflammatory changes in liver are rare--6.9%. In 37.5% changes in brain were established, embolism according to incidence being first, followed by cerebral hemorrhages, cerebral abscesses and purulent leptomeningitis Staphylococcus aureus proved to be most frequent causative infectious agent established et necropsy.

Asunto(s)

RESUMEN

Two patients are described, aged 60, with acute symptomless myocardial infarctions, diagnosed while still alive by electrocardiography, on the background of predominating neurological symptomatics, admitted as a manifestation of ischemic cerebral strokes, and in one of the patients--as embolization of peripheral artery, confirmed at operation. Multiple embolism and infarctions, with different duration, of brain and some other internal organs were established at necropsy, that originated from abacterial thromboendocarditis of aortic valve that developed in the absence of other diseases or data for the existence of disseminated intravasal coagulation. In the first case--extensive posterior-septal myocardial infarction was established and in the second--two not extensive infarctions, localized high anterior-septally and in the free anterior left ventricular wall. Though embolic deposits were not established in the large coronary arteries, the combination of acute myocardial infarctions and embolizing thromboendocarditis, in the absence of stenosing coronary atheromatosis, makes the embologenic origin of infractions most probable.

Asunto(s)

RESUMEN

The course of idiopathic congestive cardiomyopathy in two full brothers is described. The diagnosis was made on the base of the existing cardiomegaly, gallop rhythm and congestive cardiac insufficiency, in the absence of any connection with some of the well known causes for hypertrophy and dilation of the heart. It was confirmed at necropsy in one of the brothers. A similarity was established in their case history, namely: considerable physical activity until the first signs of cardiac insufficiency, advancement of decompensation at the same age (20 years) with an already existing cardiomegaly, identical complaints--rhythm disturbances and pulmonary thromboembolism, similar electrocardiographic changes with formation of "pseudoinfarct" image, ventricular flutter--immediate cause for the death of one of the brothers, sudden death--for the other. The origination of the disease cannot be associated with the effect of exogenous morbid factors. There are no data on advancing of autoimmune process. With the genealogical study, covering four generations, the family was established to have a stillborn child, no other sick members of the family, no data about multiple deaths. The cytogenetic analysis showed no chromosomal aberrations. The possibility the disease to be transmitted via autosomal recessive mode or via autosomal-dominant gene with a low penetration is discussed.

Asunto(s)

Asunto(s)

RESUMEN

The course of the disease of six cases with pheochromocytoma was analyzed in patients, aged from 19 to 65, with manifestations mainly of the cardiovascular system. The diagnosis was verified in five of them at necropsy and in one of them--intraoperatively. The arterial hypertension accompanied by distinct vegetative symptomatics were the basic clinical signs and in some of the cases--disturbances in the carbohydrate metabolism. In four patients the arterial hypertension was permanent, in two of them--with paroxysmal elevation opresf blood pressure. In the other two--with hypertonic crises on the background normal blood pressure. The duration of the hypertension--from a single hypertonic crisis during pheochromocytoma attack, had a lethal end, till the fifth year. In three of the patients rhythm disorders (supraventricular tachycardia or tachyarrhythmia) originated in a pheochromocytoma paroxysm and in three--acute left ventricular insufficiency (gallop rhythm, pulmonary edema). The clinical picture resembles heart defect, myocardial infarction with congestive cardiac insufficiency and rhythm disorders, renal insufficiency with symptomatic arterial hypertension and decompensated hypertonic heart, epilepsy, coggagenosis . The authors admit that the development of acute left ventricular failure in hypertonic patients, that could hardly be explained only by the increase of the heart afterloading (in advanced age, not enlarged and no data about grve heart lesions) or the origination of severe rhythm disorders, not coped by the modern antirhythm agents, are signs, indicating, the existence of pheochromocytoma. The catecholamine affection of myocardium, that was found in three of the deceased patients, very likely, contributes to the origination of left ventricular failure.

Asunto(s)

Asunto(s)

RESUMEN

The problem of single adenomatous polypus and adenocarcinoma of rectosigmoid is debatable. Forty eight polypi with adenomatous structure were diagnosed and total polypectomy performed with 925 rectoromanoscopic examinations. In 6 of them, zones of malignization various in dissemination, were histologically confirmed. In two of the patients intestinal resection was performed, due to invasion of the malignization within the base of the polypus. The rest, four patients, with focal superficial malignization and the other 42 patients with "pure" adenomatous polypi are subjected to periodical rectoromanoscopic observations.

Asunto(s)

Asunto(s)

RESUMEN

Analysis was made to 270 deceased with acute myocardial infarction. The signs discussed were: type of coronary circulation, sex and age, nosological belonging, atherosclerosis affection and allocation of thrombosis in coronary arteries. The acute infarction lesions were characterized according to site, layers involved, left ventricular mass engaged mural thrombosis and acute aneurysms ruptures. Consideration was given to myocardiosclerosis, postinfarction cicatrices and chronic aneurysms, hypertrophic rate, duration of recent infarction, thromboembolic complications and death causes. Essential discrepancies were found for the separate coronary types as regards stenosis distribution, predominating affection of separate coronary vessels, site of coronary thrombosis, infarction, resp., infarction extent (layer and mass), rupture incidence, acute aneurysms and postinfarction cicatrices. The study revealed that left coronary type was the most unfavourable terrain for acute myocardial infarction.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Analysis was performed on 220 cases--decreased with acute myocardial infarction, subdivided into two groups--not hypertonics and hypertonics. The average age of the decreased with acute myocardial infarction with arterial hypertension is higher. Substantial differences are absent in the carriers of coronary type, degree of atherosclerotic affection and coronaries myocardiosclerosis and past infarctions, preceding the development of the acute myocardial infarction, being the cause of the death. Coronary thrombosis, mural thrombosis, acute aneurysms, and embolic complications in the systemic and pulmonary circulation proved to be more frequent among hypertonic. Discrepancies are absent as regards the localization of the necrotic zone and involvment of the ventricular muscles. Rupture incidence in both groups is very high and almost the same--over 25 per cent. External ruptures are found to be more frequent, being most often posterior in hypertonics. Parillary ruptures are characteristic for them. No difference is established concerning the exitus. Left ventricle insufficiency ranks first for both groups--over 67 per cent; second to follow are the heart ruptures with tamponade--about 20 per cent; and third--the arterial embolias in systemic circulation--9--10 per cent.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Analysing the Ecg and VCG of 818 subjects, healthy or with different congenital and acquired cardiopaties, the frequency of right bundle branch block (RBBB) is established to decrease with the increase in age of children, and is observed to be 8.9% in healthy adults. The right bundle block is observed in 82.5% of the patients with atrial septal defect and quite often in patients with right ventricle tension loading, gradually decreasing with the level of the left ventricle loading, as well as with the development of extreme right ventricle hypertrophy. Out of 50 experiments with dogs with acute and chronic right heart tension loading it is evident that the number of certain and marginal (uncertain) cases with RBBB steadily increases. At the same time this increase cannot be connected with the type of loading, in dogs in which dilatation of the right ventricle is presented as well as in others with light or marked hypertrophy. Besides, under the same conditions and durations of loading some hearts exhibit RBBB, while others do not. What has been stated before gives enough grounds to accept that RBBB in healthy subjects, as well as in patients with congenital and acquired cardiopaties manifests the electromotive tension (EMT) of persistent from foetal and children-age more pronounced physiological hypertrophy (as normal variant) of the basal part of the right ventricle. Whether the picture of RBBB is retained, pronounced or disappears is determined by the correlation between the quantity and the time-manifestation of EMT of the left ventricle and of the corps part of the right ventricle.

Asunto(s)

RESUMEN

Changes in the liver, stomach, small intestine, kidneys, lungs, myocardium, aorta, spleen and mesenterial lymph nodes are studied histologically in 120 male white rats from the Wistar line, subjected to a deficient alimentation regime, with and without physical exertion. The observed slight degree of adiposogenital dystrophy of the liver during free feeding regime indicates that the latter is equivalent to overfeeding. Variations from the normal histological picture in some organs (liver, myocardium, stomach and small intestine) are detected in the groups undergoing rather prolonged, moderate undernourishment--a sign of the sensitivity of these organs to the limited supply of nutritive ingredients. Physical loading, combined with free alimentary regimen, exert a beneficial effect on the organism which is suggested by the morphological data disclosing a slightly enhanced function of the myocardium and kidneys in these animals.

Asunto(s)