Formation of deposits on the surfaces of superheaters and economisers of MSW incinerator plants.

Mineralogical and chemical investigations of deposits from superheaters and economisers from a MSWI plant in Mannheim, Germany, lead to a classification system which provides information about the most critical parameters leading to fouling and corrosion. With the help of this classification system parameters like the geometry of boilers and the waste input can be changed in order to prolong run times between revisions and enhance energy efficiency of MSWI plants.

Effect of short-term natural weathering on MSWI and wood waste bottom ash leaching behaviour.

Short term natural weathering was applied on municipal solid waste (MSW) and wood waste incinerator bottom ash (BA). The materials were analysed at different steps of treatment and characterized for chemical and mineralogical composition. Both short and long term leaching behaviour of main elements and heavy metals were investigated as well. Lead, zinc and copper were the main heavy metals to be released. After 12 weeks of treatment the concentration of leached zinc decreased. Lead concentration was not found to be influenced by pH and decreased only for the biomass samples. Weathering did not have beneficial effects on copper leaching, which was well described by complexation processes with DOC. The findings from the experimental campaign indicated that weathering reactions improved the mineral stability of the analysed materials but, in contrast with previous works, the treatment was not sufficient to guarantee pH stability and to comply with leaching law limits.

Hepatocyte proliferation and cell cycle phase fractions in chronic viral hepatitis C by image analysis method.

OBJECTIVE: Chronic hepatitis is characterized by necrosis of liver cells, accompanied by an inflammatory reaction and compensatory cell proliferation. The interaction of the core and non-structural proteins of hepatitis C virus (HCV) with several cellular factors suggests that cell proliferation may be influenced by HCV. The aim of this study was to investigate hepatocyte proliferation and DNA ploidy patterns in patients with chronic viral hepatitis C (CH-C) compared with chronic non-viral hepatitis (CH-N), using a TV image analysis method. METHODS: The DNA index (DI) and cell phase fractions (G1, S, G2) were measured by means of digital picture analysis method on nuclear suspensions of Feulgen stained hepatocytes. Cells were taken from the liver biopsy specimens of 71 patients with CH-C and 24 patients with CH-N. Twenty-six normal liver samples were used as controls. RESULTS: Significantly higher G1 (94 +/- 4) and lower S (3.56 +/- 3.16) phase fractions were measured in CH-C compared with CH-N (G1, 90 +/- 6; S, 6.4 +/- 5.99). The DI of moderate (1.12 +/- 0.05) and severe (1.12 +/- 0.05) CH-C showed near-aneuploid DNA content, while diploidy (DI < 1.10) was detected in cases of CH-N. CONCLUSION: The higher G1 and lower S cell cycle phase fractions in CH-C reflect decreased hepatocyte proliferation compared with CH-N. The near-aneuploid DNA content of the HCV-infected liver samples may be a sign of increased genetic instability, which may contribute to the carcinogenic potential of HCV.

Clinical and biological findings in a case with 48-hour bipolar ultrarapid cycling before and during valproate treatment.

BACKGROUND: The rare cases of patients with 48-hour ultrarapid cycling allow close investigation of mood cycles in affective disorders, because rhythmic changes in psychopathologic state and biological parameters happen very precisely. METHOD: A 67-year-old white man who had experienced bipolar 48-hour ultrarapid cycling (DSM-IV 296.80) for several years was studied without any medication and then again studied 4 weeks later during treatment with valproate (1800 mg/day). RESULTS: Objective and self ratings revealed pronounced manic states 1 day and depressed states the following day, which were found to be accompanied by rhythmic fluctuations in behavior and electroencephalographic parameters, blood cortisol and growth hormone levels (both elevated on depressive days), and urinary metanephrine (dopamine metabolite) and norepinephrine levels (both elevated on manic days). Using single photon emission computed tomography, regional blood flow in the left thalamus was lower than in the right thalamus on the manic day, while symmetric perfusion of the thalamus was found on the depressive day. Under valproate treatment, the patient remitted completely, and significant rhythmic changes in most of the biological parameters were no longer detectable. CONCLUSION: The biological findings in this patient with bipolar 48-hour ultrarapid cycling, which correspond to those in other types of affective disorders, suggest that disturbances in the diencephalon-pituitary axis may be especially correlated to pathologic changes of mood.

The loudness dependency of the auditory evoked N1/P2-component as a predictor of the acute SSRI response in depression.

RATIONALE: A serotonergic dysfunction is supposed to play a pathogenetic role in depression, but there is a considerable number of non-responders in the acute treatment of depression with serotonergic agents like SSRI. Thus, an indicator of central serotonergic activity could lead to a more specific pharmacological treatment of depression. In animal and human data there is a growing amount of evidence that a strong loudness dependency of late auditory evoked potentials (LDAEP) is an indicator of low serotonergic activity and vice versa. OBJECTIVE: In 29 depressive inpatients (DSM-III-R diagnosis 296.x in 28 patients, 300.4 in one patient), the hypothesis was tested that a strong LDAEP prior to treatment can predict a better clinical outcome under SSRI treatment over 4 weeks. RESULTS: Patients with a strong pre-treatment LDAEP had a significantly greater decrease of depressive symptoms (Hamilton Scale for Depression) after 4 weeks than patients with a flat LDAEP. Significantly more responders fell into the group with a high LDAEP. Contrary to what might be expected, a second recording in a subsample of 19 patients after 4 weeks of treatment failed to show changes in the LDAEP. CONCLUSION: Our finding confirms the hypothesis that a strong LDAEP, indicating a low serotonergic activity, is related to a favorable response to acute SSRI treatment in depression. The LDAEP is a promising tool for the prediction of response to serotonin agonists in depression and it seems to be of clinical importance.

Psychostimulants in the therapy of treatment-resistant depression Review of the literature and findings from a retrospective study in 65 depressed patients.

The use of psychostimulants as an adjuvant therapy in treatment-resistant depression is not very common nowadays and has been the subject of much criticism. This article gives a brief review of the literature and reports on the findings from a retrospective study carried out in 65 depressed patients treated with psychostimulants (amphetamine and methylphenidate) in addition to conventional antidepressants. Thirty-eight out of 65 patients showed significant improvement, in particular with respect to energy mood, and psychomotor activity. The best response to psychostimulants was seen in inhibited types of depression and in combination with a tricyclic antidepressant. None of the patients developed drug dependency. The incidence of side effects was low, and agitation and restlessness improved with an additional short-term treatment with benzodiazepines. It is concluded that the rapid onset of action (2-3 hours) after administration may help cover the therapeutic latency period of conventional antidepressants and probably potentiates their effect. In view of their potential benefits in treatment-resistant depressive states, psychostimulants should be tried more often.

[Support by telecommunication of decisions in diagnostic pathology. Experience with the first telepathology system in Hungary]. / Telekommunikációs döntéstámogatás a diagnosztikus patológiában. Tapasztalatok az elsó hazai telepatológiai rendszerrel.

The term of telepathology can be determined as diagnostic work of the pathologist at distance via an interactive telecommunication connection in which the image of the specimen appears on a monitor instead of viewing it directly through a microscope. Being a part of the telemedicine, the fast development of the telepathology is based on the revolution of the new digital technology. Technical advances of telecommunication and of image procession in the latest 80s have provided the means to transfer huge amount of visual information in narrow communication bandwidth in two direction link. In 1995 multiple live image transmission with simultaneous voice transfer has been performed between the Department of Pathology of MI Central Hospital and 1.st Institute of Pathology and Experimental Cancer Research of Semmelweis Medical University, Budapest. Transfer rate via ISDN channel was 128 kbit/sec. The first live image telemedicine system in CCE/NIS countries has achieved transmission of cytological smears, frozen sections and paraffin embedded slides supplemented with immunohistochemical preparations. Quality of visual information using video-conference software of standard H.320 was suitable for diagnosis. Development of global telepathology services depends on compatibility of different systems and on comprehensive examinations of cost, accessibility and quality for the clients and providers of telemedicine. Recent paper surveys shortly the historical development of the telepathology, analyses the essence of the new consultation technology, summaries the first experiences in Hungary and raises some questions have to be answered in the near future.

[Immunohistochemical study of hepatitis B and D virus antigens (HBsAg, HBcAg, HDAg) in chronic liver diseases]. / Hepatitis B és D vírusantigének (HBsAg, HBcAg, HDAg) immunhisztokémiai vizsgálatának jelentósége idült májbetegségekben.

Authors have investigated the hepatitis B and D virus antigens in the liver tissue of 30 HBsAg and/or anti-HD seropositive patients (23 males, 7 females, age: 20-65, mean: 44 years) by immunohistochemical method. The immunohistochemical identification of HBsAg, HBcAg and HDAg in 42 liver sample (36 obtained by percutaneous biopsy, 6 from dissection) of 30 patients was performed with Dako and Sorin Biomedica kits. The detailed virus serologic examinations were carried out with Biomedica and Abbott kits by radioimmunoassay and ELISA methods. Examining 36 liver tissue samples of 27 HBsAg seropositive patients, HBsAg could be demonstrated in 31 cases. Each patient suffering of active HBV and/or HDV replication was HBsAg positive by immunohistochemistry, while the tissue samples of patients in integrational phase of HBV infection were positive in only 9 cases of 14. There was no HBsAg tissue positivity in HBsAg seronegative cases. 7 of 16 tissue samples of 12 patients classified to active HBV replication state were HBcAg positive by immunohistochemistry. HBcAg could be detected in the liver tissue of each HBe seropositive patient, while in only 3 of 8 cases with only IgM anti-HBc seropositivity (indicating low level of HBV replication). Tissue HBcAg positivity, indicating active virus replication, was verified in 2 of 11 patients classified to HBV integration state by serology. Authors detected HDAg tissue positivity only in cases with serologically active HDV replication (IgM anti-HD seropositive) and HDAg could also be identified from liver tissue in each IgM anti-HD seropositive case. No HBsAg, HBcAg and HDAg tissue positivity was observed in HBsAg negative cases. Authors emphasise mainly the importance of immunohistochemical detection of HBcAg and HDAg completing the serologic diagnosis of chronic HBV and HDV infections, helping the verification or exclusion of active virus replication being essential for selecting adequate therapy.

Comparative scanning of thyroid nodules with technetium-99m pertechnetate and technetium-99m methoxyisobutylisonitrile.

Thyroid imaging was performed using technetium-99m methoxyisobutylisonitrile and technetium-99m pertechnetate in 58 patients. The 99mTc-pertechnetate scans showed a total of 77 nodules: 60 cold, 13 hot and 4 of normal activity. There was no 99mTc-MIBI accumulation in 46.4% of 99mTc-pertechnetate cold nodules; 27 (45%) of these nodules showed 99mTc-MIBI uptake with the same intensity as the surrounding normal tissue, and five (8.6%) became hot with 99mTc-MIBI. Of the 99mTc-pertechnetate hot nodules 11 (84.6%) could not be differentiated from the normal extranodular tissue on the 99mTc-MIBI scan. The histopathology of 34 surgically removed nodules proved that increased, normal or decreased 99mTc-MIBI accumulation is not specific for thyroid malignancy and that the 99mTc-MIBI uptake depends mainly on the viability of thyroid tissue.

Laryngospasm during transtracheal high frequency jet ventilation.

A 74-year-old woman developed severe cardiovascular depression during percutaneous transtracheal high frequency jet ventilation for laser surgery of the epiglottis. This was found to be caused by acute airway obstruction secondary to severe laryngospasm. We recommend profound neuromuscular blockade during percutaneous transtracheal jet ventilation, in order to prevent this complication.

The incidence of hepatitis delta virus infection in chronic liver diseases in Hungary.

A study of hepatitis B and D virus markers in 118 hepatitis B virus seropositive patients suffering from histologically confirmed chronic liver disease is reported. The prevalence of hepatitis delta infection amounted to 13.6%, whereas active hepatitis delta virus replication was proven in 6 of the cases. On the basis of these findings, conclusions--similar to those published earlier--are drawn about the role of hepatitis delta virus in the progression of chronic liver diseases. It is suggested that HBsAg-IgM complex seropositivity in patients suffering from anti-delta positive chronic liver disease supports active hepatitis delta virus replication.

The significance of detailed hepatitis B virus serology in chronic liver diseases.

Hepatitis B virus (HBV) markers were studied with Sorin RIA kits in serum samples from 390 patients suffering from histologically confirmed chronic liver disease. On the basis of negative HBsAg, anti-HBs, anti-HBc tests, HBV infection was excluded in 235 of the cases. The diagnosis was fatty liver and/or alcoholic hepatitis in 52%, while chronic active hepatitis and/or liver cirrhosis only in 21.7%. Part or present HBV infection was proven in 155. In 53% of these cases the diagnosis was chronic active hepatitis and/or liver cirrhosis, whereas fatty liver and alcoholic hepatitis occurred in 27.7%. Detailed HBV marker analysis was performed in 76 patients. Previous infection without replication (positive anti-HBs and/or anti-HBc and/or anti-HBe) was proven in 48 cases, 12 patients had active HBV infection (positive HBsAg, HBe, IgM anti-HBc), while in 16 cases HBV integration (positive HBsAg, anti-HBc, anti-HBe) was proven. HBsAg-IgM complex seropositivity was shown in every case with active HBV replication. Because of therapeutic, prognostic and epidemiologic reasons, the significance of detailed HBV serology in chronic liver diseases is stressed.

Ultrasonography and water content of the liver in chronic diffuse liver disease.

Water content in the liver in vivo was determined in 89 patients (33 with normal liver and 56 with chronic liver disease), simultaneously with ultrasonography and histopathological examination. A part of each biopsy specimen was used for this purpose. The difference between wet and dry weights was calculated from the pre- and post-lyophilization weights. According to the attenuation type of ultrasonic images, the patients were divided into two groups, viz., patients of low attenuation type (i.e. patients with type I bright liver) and those of high attenuation type (i.e. with type II bright liver). As to water content, no significant difference was observed between the two groups. No correlation was found between liver water content and histopathology either. It is concluded that knowledge of correlation between numerous parameters is needed to clarify the reason of attenuation differences.

Genetic and biochemical studies on flavonoid 3'-hydroxylation in flowers of Petunia hybrida.

In flower extracts of defined genotypes of Petunia hybrida, an enzyme activity was demonstrated which catalyses the hydroxylation of naringenin and dihydrokaempferol in the 3'-position. Similar to the flavonoid 3'-hydroxylases of other plants, the enzyme activity was found to be localized in the microsomal fraction and the reaction required NADPH as cofactor. A strict correlation was found between 3'-hydroxylase activity and the gene Ht1, which is known to be involved in the hydroxylation of flavonoids in the 3'-position in Petunia. Thus, the introduction of the 3'-hydroxyl group is clearly achieved by hydroxylation of C15-intermediates, and the concomitant occurrence of the 3',4'-hydroxylated flavonoids quercetin and cyanidin (paeonidin) in the presence of the functional allele Ht1 is due to the action of one specific hydroxylase catalysing the hydroxylation of common precursors for both flavonols and anthocyanins.

Genetic and biochemical studies on the conversion of flavanones to dihydroflavonols in flowers of Petunia hybrida.

Chemogenetic investigations and precursor experiments on flowers of Petunia hybrida suggest that recessive alleles of the gene An3 block the biosynthetic pathway of flavonols and anthocyanins between the flavanone and dihydroflavonol step. In confirmation of this hypothesis, activity of the enzyme flavanone 3-hydroxylase, which catalyses the conversion of flavanones to dihydroflavonols, was readily demonstrated in enzyme preparations from flowers of lines with the dominant allele An3, whereas no or very low activity could be found in extracts from lines with recessive alleles (an3an3). A second genetic factor is described which clearly reduces the amount of flavonols in the flowers but not the amount of anthocyanins. Crossing experiments revealed that this factor represents a third allele of the An3 gene. It is referred to as an3-1. As expected, a residual flavanone 3-hydroxylase activity of about 10% could be found in enzyme extracts from plants with the an3-1 allele. The decreased level of dihydroflavonol formed under this condition is obviously still sufficient for anthocyanin formation but not for flavonol synthesis.Similar to flavanone 3-hydroxylases from other plants, the enzyme of Petunia is a soluble enzyme and belongs according to its cofactor requirements to the 2-oxoglutarate-dependent dioxygenases. The residual flavanone 3-hydroxylase activity found in plants with the an3-1 allele is identical to the activity extracted from An3-genotypes with regard to cofactors, substrate specificity and most of the inhibitors. The difference observed in the respective pH-optima and the genetic data suggest that the mutation providing the an3-1 phenotype is localized in the structural gene for flavanone 3-hydroxylase.

Clinical, enzymological and histological changes in chronic diffuse liver diseases following (+)-cyanidanol-3 (Catergen) treatment.

The effect of (+)-cyanidanol-3 (Catergen) monotherapy was examined in 18 patients with alcoholic liver disease and in 12 patients with chronic active hepatitis. During the administration of the drug the majority of complaints diminished or ceased in both groups. In patients with alcoholic liver disease bromsulphalein retention and gamma glutamyl transferase levels decreased, in chronic active hepatitis serum glutaminic pyruvic acid transaminase (SGPT) and alkaline phosphatase levels increased, pseudocholinesterase level decreased. The histological abnormalities of alcoholic liver injury improved in the majority of cases, on the other hand, it was deteriorated in two third of the cases with chronic active hepatitis. In two cases the histological recovery of acute alcoholic hepatitis was observed. On the basis of this results we conclude that Catergen has an excellent therapeutic effect in alcoholic liver injury while in chronic active liver diseases it can be applied only as a part of combined therapy.

Flavonoid Biosynthesis in Flowers of Verbena hybrida.

Extracts from flowers of different strains of Verbena hybrida were found to contain flavones, flavonols, and anthocyanins. Furthermore, the presence of flavanones and dihydroflavonols was demonstrated. With regard to the B-ring substitution pattern, flavonoids with hydroxy groups at the 4'-, the 3',4'-, and the 3',4',5'-positions were found to occur. Red flowering strains contain 4'- and 3',4'-hydroxylated flavonoids in varying amounts. Enzymic studies revealed that the compounds with the 3',4'-hydroxylation pattern can be established by two different reactions. A small part of them is formed by incorporation of caffeic acid beside p-coumaric acid into the flavonoid skeleton during the condensation reaction catalysed by chalcone synthase. This basic level can be considerably enhanced by hydroxylation of 4'-hydroxylated flavonoids in the 3'-position. The reaction is catalysed by the well-known enzyme flavonoid 3'-hydroxylase. Enzyme activity was found to be correlated with the presence of enhanced amounts of 3',4'-hydroxylated flavonoid compounds in the flowers. Beside chalcone synthase and 3'-hydroxylase a further enzyme activity could be demonstrated in enzyme preparations from flowers of Verbena hybrida which catalyses the oxidation of naringenin to apigenin and of eriodictyol to luteolin. The reaction required NADPH as cofactor and had a pH optimum of about 6.5. Enzyme activity was found to be localized in the microsomal fraction.

Selection and characterisation of flavanone 3-hydroxylase mutants ofDahlia, Streptocarpus, Verbena andZinnia.

Precursor experiments and chromatographic studies indicate that the hydroxylation of flavanones in the 3-position to dihydroflavonols is blocked in special white-flowering mutants ofDahlia, Streptocarpus, Verbena andZinnia. The result of our investigations was confirmed in as much as the activity of the enzyme flavanone 3-hydroxylase, which catalyses the conversion of flavanones to dihydroflavonols, could readily be detected in flower extracts of cyanic strains of the four plant species. It was found to be, however, completely absent in flower extracts of the corresponding acyanic mutants. Thus, the interruption of the anthocyanin pathway in these mutants is clearly caused by a lack of this enzyme activity. Similar to the enzymes from other sources, the 3-hydroxylases ofDahlia, Streptocarpus, Verbena andZinnia are soluble enzymes; they belong to the 2-oxoglutarate-dependent dioxygenases and the reaction is inhibited by ethylenediaminetetraacetic acid, KCN and diethyldithiocarbamate.