[Formulation possibilities of self-emulsifying drug deliv- ery systems, microemulsions and nanoemulsions.] / Not available.

Objective The aim of this review is to introduce the self-emulsifying drug delivery systems which can be used to improved the bioavailability of poorly water soluble drug substances. Methods The review summarizes the most prominent results of the lipid based medicinal preparations, such as microemulsions and nanoemulsions developed in the last two decades. Results The analysis of the references details the lipid based formulation classification systems, the most common excipients, the quality attributes depending on the ingredients, as well as the differences in the characteristics of micro- and nanoemulsions. Conclusions The summary demonstrates the formulation possibilities of self-emulsifying drug delivery systems, which may increase the applicability and are promising to improve the therapeutic effectiveness.

Chronical cervical infections and dysplasia (CIN I, CIN II): Vaginal vitamin D (high dose) treatment: A new effective method?

In a small praxis/ambulance study we evaluated data of 200 women with chronical recurrent cervical infections and with a cervix dysplasia (CIN 1, CIN 2). who got after the primary therapy a treatment with vitamin D vaginal suppositories (12.500 IU, 3 nights a week, for 6 weeks). We found that - when compared with the lactobacillus vaginal suppositories - the high dose vitamin D vaginal treatment might be more effective. Vitamin D showed very good anti-inflammatory effects. In the survey after six weeks therapy 79% of the women had "less vaginal problems," "less discharge" and "less problems with the sexual intercourse." Objectively after six weeks therapy only 7% of the patients still had bacterial and/or fungal vaginal infections that required a treatment. We found that vitamin D is reabsorbed by the vaginal mucosa, but the reabsorption may be individually very different. In the CIN 1 group we found six weeks after treatment good antidysplastic effects, in the CIN 2 group we often found no or only temporary antidysplastic effects. So this vaginal vitamin D treatment method might be an option for the therapy and prevention of chronical cervical infections and maybe of a cervic dysplasia CIN 1 (good antiinflammatory effects, antidysplastic effects). This small study is not representative. We need much bigger studies with much more dates and with a longer follow up. Caution: At the moment we do not know, if the vaginal vitamin D treatment with 12500 IE is possible in pregnancy. We have no experience. Therefore we recommend an effective contraception during the application.

The influence of homocysteine and oxidative stress on pregnancy outcome.

Oxidative stress in utero-placental tissues plays an important role in the development of placental-related diseases. Maternal hiperhomocysteinemia is associated with placental mediated diseases, such as preeclampsia, spontaneous abortion and placental abruption. The aim of our study is to appreciate the clinical usefulness of the dosage serum homocysteine and malondialdehyde, as an oxidative stress marker, in the pregnancies complicated with risk of abortion or preterm birth. The study was performed at the Obstetric Gynecology Clinical Hospital Oradea from December 2009 until April 2010. It included 18 patients with risk of abortion (group 1), 22 with preterm birth (group 2). The results were compared with a control group composed by 14 healthy pregnant women. Serum homocysteine level was measured by an enzymatic method, on the instrument Hitachi 912, Roche, reagent: Axis-Shield Enzymatic. For proving the oxidative stress we established the level of malondialdehyde using a method with thiobarbituric acid TBA (Kei Satoh 1978) and the level of ceruloplasmin with the Ravin method .Also AST, ALT,CRP, iron, uric acid, urea were assessed.High level of homocysteine in both groups of study in comparison with the control group was found. The concentration of MDA was significantly higher in pregnancies complicated with risk of abortion and preterm birth compared to the control group (p=0.040, p=0.031). Considerable differences of ceruloplasmin concentration between group 1 and group 2 (p=0.045), and between group 2 and control group (p=0.034), was noticed but not any important differences between group 1 and control group (p=0.683). In women with risk of abortion or with preterm birth an oxidative stress and a hyperhomocysteinemia are present.

Retrospective evaluation of 5-fluorouracil-interferon-a aTreatment of advanced colorectal cancer patients.

The authors describe the retrospective analysis of treatment by 5-fluorouracil and interferon-a aof 34 patients with advanced colorectal cancer. An average of 4.6 treatment cycles (3 12) was applied. Complete remission was not observed; partial remission was observed in 8 patients; in 13 patients no change occurred and progression was detected in 14 cases. Remission rate was 22.8%, mean response time was 5.2 (3 12) months, mean progress-free survival 5.6 (0 22) months. Mean survival from the start of treatment was 11.9 (1 42) months and from the establishment of the diagnosis 26.1 (3 60) months. Severe life-threatening side-effects did not occur; other side-effects such as fever, nausea, diarrhea, leucopenia, and anemia responded to drugs. Treatment by 5-FU and interferon, in accordance with other authors findings, improved survival and well-being of patients but no breakthrough has been achieved.

High mitotic index associated with poor prognosis in gastrointestinal autonomic nerve tumour.

AIMS: Three gastrointestinal autonomic nerve tumours (GANT) were characterized by immunohistochemistry and flow cytometry. Two of the three cases occurred in the small intestine, while the third was found in the stomach. Besides the immunohistochemical and ultrastructural description, the aim of this study was to examine the relation between the known and accepted predictive factors (ploidy data, the S-phase fraction, the mitotic and MIB-1 index and the size of the tumour) and the survival of the patients. METHODS AND RESULTS: The immune profile showed that 3/3 cases were vimentin and NSE, 2/3 were synaptophysin and PGP 9.5 positive, while 1/3 also showed S100 positivity. Ultrastructurally, all the cases had dense core granules, one of them contained skenoid fibres. The flow cytometry revealed diploid DNA in all cases, however, significant differences could be seen in the proliferative activity of the individual neoplasms. CONCLUSIONS: In spite of the published data of gastrointestinal stromal tumours (GIST) generally, neither the MIB-1 index and the ploidy data nor the size of the primary tumour helped to predict the clinical progression of the examined GANTs. However, the high proliferative activity (57 mitoses/10 HPF) and the elevated S-phase fraction (24%) was associated with advanced, metastatic and recurring disease in case 3. On the basis of these three cases, high mitotic activity is the most reliable factor in predicting aggressive clinical behaviour.

[Membrane diffusion of paracetamol]. / A paracetamol membrándiffúziós vizsgálata.

A study was made of how different cyclodextrin (CD) derivatives, such as alpha-CD, beta-CD, gamma-CD, dimethyl-beta-CD and random-methyl-beta-CD, influence the diffusion of paracetamol. For interpretation of the phenomena, dissolution rate investigations, measurements of surface tension and determinations of partition coefficients were also performed. It was established that paracetamol has a low diffusion ability. It was also found that the different CD derivatives exert their influence in diverse ways, which depend on, among others, the cyclodextrin ratio and the mode of preparation of the product. These complementary examinations are useful for an explanation of the phenomena.

[Experience with the Matti-Russe-Zolczer method in the surgical management of pseudoarthrosis of the navicular bone of the wrist]. / Matti-Russe-Zolczer-mütéttel szerzett tapasztalataink a kéz sajkacsont álízületének kezelésében.

Authors performed in the Department of Traumatology of the County Hospital Kaposvár from 1979 to 1985 22 Matti-Russe-Zolczer operations for pseudoarthrosis of the navicular bone. The necessity of the strict observance of the conditions of indication is stressed. The results of operations were assessed in a follow-up. The time elapsed between the operation and control was 2 and 6 years. Good results were achieved after the use of Matti-Russe-Zolczer operation in 22 patients with navicular pseudoarthrosis.

Intraglomerular embolization by tubular cells.

Intraglomerular embolization by tubular epithelial cell is a rare artefact found in needle biopsy specimens. The authors have observed this phenomenon in five out of 300 renal biopsy cases. Tubular epithelial cells, were present in the glomerular capillaries (in two cases) or in the capillaries and within the glomerular urinary space (in three cases).

Immunological investigations in acute and chronic human pancreatitis.

Follow-up immunological studies in 27 patients with acute pancreatitis of known etiology showed a significant elevation in the level of circulating immune complexes (IC), a significant inhibition in migration of leukocytes (with direct LMT) of patients and a significant decrease in the percentage of T-active, T-total peripheral lymphocytes and in the absolute count of peripheral T cells. Elevated circulating IC levels could been detected 3-4 weeks after the onset of acute pancreatitis. These immunological changes have still been demonstrated in a number of patients 7-14 months after recovery. We have found similar immunological alterations in patients with chronic pancreatitis as well. The possible causes and role of these long-term existing immunologic abnormalities are discussed.

Abnormalities in humoral and cellular immunoactivity in pancreatitis. II. Study of the cellular immune system.

The in vitro parameters of the cellular immune system were followed up during the course of, and over 1 to 8 months after recovery from acute pancreatitis and in chronic pancreatitis. In acute pancreatitis, a significant inhibition of leucocyte migration and a significant reduction of the percentage and absolute number of early and total rosette-forming (T) lymphocytes were demonstrated. These abnormalities ran parallel with the alterations of the humoral immune system described in the first paper of this series. On the evidence of the follow-up studies continued for 1 to 8 months, the abnormalities of the cellular and humoral immune system were found to persist in the majority of the cases. The same is valid for chronic pancreatitis. The possible causes of the abnormalities are discussed. Tentative interpretations are offered for the possible role of specific immune sensitization in the transition of the acute to the chronic inflammatory process and in the progression of chronic inflammation.

Abnormalities in humoral and cellular immune activity in pancreatitis. I. Study of the humoral immune system.

The abnormalities of the humoral immune phenomena in pancreatitis may be summarized on the grounds of published evidence and of the present results as follows: 1. Circulating anti-pancreas antibodies are present in acute pancreatitis as also after its cure, and in chronic pancreatitis. 2. The appearance of soluble immune complexes in pathological amounts was demonstrated in the sera of the patients by radiobioassay in acute pancreatitis of identified aetiology 3 to 4 weeks after onset. On the evidence of follow-up studies over 1 to 8 months the immune complexes were found to persist at increased levels after complete cure of acute pancreatitis. Soluble immune complexes were demonstrable in pathological amounts in the cases of chronic pancreatitis as well. 3. In acute pancreatitis the total serum complement titres decline fast and after a few weeks persistent hypocomplementaemia develops in a number of cases. 4. The possible role of circulating soluble immune complexes and of the complement system in pancreatitis is discussed, and it is suggested on the grounds of the present data that acute pancreatitis is associated with a specific and nonspecific immune sensitization, still demonstrable in a number of cases after a few months.