[Angiotensin converting enzyme inhibitors in controlled hypotension during spinal surgery]. / Inhibitory angiotenzin konvertujícího enzymu v rízené hypotenzi behem spondylochirurgických výkonu.

BACKGROUND: Controlled hypotension is an advantage during spondylosurgical operations: the objective is to achieve a mean arteriae pressure of 8 kPa (60 mm Hg). The most frequently used 0.01% solution of sodium nitroprusside must be increased in some patients to amounts which involve the risk of intoxication. This applies to patients with an increased sympathoadrenal activity and ready mobilization of the renin-angiotensin system. The objective of the present investigation was to test the inhibitor of the angiotensin converting enzyme in hypotension controlled by nitroprusside. METHODS AND RESULTS: To twenty patients before a spondylosurgical operation as premedication angiotensin converting enzyme inhibitor (ACE)--captopril--was administered, 25 mg by the oral route. The control group was formed by 20 patients with spondylosurgery under controlled hypotension with nitroprusside administration. The effect of captopril was manifested by a reduced amount of nitroprusside needed to maintain the median pressure of 8 kPa; in the captopril group 1.073 +/- 0.52 microgram.kg-1.min-1 was used, as compared with 1.786 +/- 1.04 micrograms.min-1 in the control group (p < 0.01). Concurrently monitored values of plasma renin activity were higher in the patients given captopril: 7.352 +/- 5.75 nmol.l-1, as compared with 5.583 +/- 3.73 nmol.l-1 (p < 0.05). CONCLUSIONS: Premedication with ACE inhibitor (captopril), even when administered in small doses via p. o., reduced the sodium nitroprusside consumption by as much as 60%. The elevated plasma renin values were objective evidence of the effect of captopril.

[Reoperation for recurrent carcinoma of the large intestine and rectum]. / Reoperace pro recidívu karcinomu tlustého streva a konecníku.

Based on their own experience with reoperations of relapses of colorectal carcinoma the authors draw attention to the very poor results of these operations; even in case of early detection of a relapse of the tumour in the majority only a palliative operation could be performed and only in 10% patients a radical operation. Therefore the authors emphasize prevention of relapses.

Human nutrition and internal medicine.

An abbreviation review explaining partly the role of human nutrition science in medicine shows that this very branch of medicine is not fully covered by dietetics, food hygiene or so-called metabolism as such. It forms on the contrary a special interdisciplinary part of it (such as e. g. clinical pharmacology) with its own methodology and field of research. Its large extent--from e. g. inborn errors of metabolism and their correction to illnesses caused by some substrate deficiency (malnutrition, hypovitaminosis, lack of minerals or microelements) or secondarily induced deficits of some enzymes etc.--can lead to regulatory, structural or functional disturbances in humans' organism. On the other side there is a lot of serious health impairments induced indirectly from overfeeding with energy or some imbalance food pattern as shown in the case of over doses of fat. Many other combinations of different factors (e. g. imbalance of fat and lack of some micronutrient, overdoses of vitamins or minerals) can enter into pathophysiology and should be subjects of further studies.

[Does nutrition influence the propagation of neoplasms?]. / Beeinflusst die Ernährung die Neoplasmanausbreitung?

In the last years, questions concerning the relationship between nutrition and the occurrence of neoplasms have been studied more intensively. The author discusses the possible involvement of water as a potential carrier of certain cylic hydrocarbons and radionuclides, and of nutrition per se. He treats problems related to, inter alia, bulk materials, polyethenoid fatty acids, the increase in fat consumption, trace elements, vitamins and the importance of the intestinal flora.