Oxidative injury and other metabolic disorders in hepatic encephalopathy.

Within the complex mechanism of hepatic encephalopathy resulting from alcohol poisoning, a significant pathogenic role seems to relate to lipid peroxides (free radicals generated by chronic alcohol poisoning itself). Oxidative aggression is emphasized by the diminishing antioxidative capacity of the body resulting from serious liver injury brought about by chronic ethyl poisoning. The poisoning influences the whole functional capacity of the liver, hepatic protein synthesis included, which also means ceruloplasmin and siderophilin synthesis; the two latter elements make up AOS Cp-Tr which neutralizes the harmful activity of Cu and Fe excess and stimulates release of free radicals of oxygen. The purpose of our research was to study the redox balance alteration in blood in a group of patients who were in a critical condition and had been admitted to the somatic patients ward of the "Prof. Dr. Alexandru Obregia" Neurology and Psychiatry Hospital and who were suffering from hepatic encephalopathy resulting from ethyl poisoning.

Dynamic study of oxyhemoglobin in traumatic shock.

The dynamic study of oxyhemoglobin in general, and especially in traumatic shock, represents one of the aspects of pathophysiology which is of interest to practitioners as well as to pathophysiologists due to its relatively practical accessibility. The study was performed on two groups of 30 subjects: a healthy subjects group and a control group. The patients hospitalized in the Intensive Care Section of the Clinical Hospital Department of Constanta represented the subjects of the control group. Using an Oximeter--AVL 912 oxylite, the arterial hemoglobin oxygen saturation, venous hemoglobin oxygen saturation and the calculation of arterio-venous oxygen difference were measured in their dynamics. The results showed a diminution of oxygen extraction at the tissular level. We also noticed a good correlation between oxyhemoglobin dynamics and the evolution of the patients during specific therapy.

Antioxidant protection in collagen-vascular diseases.

Alteration of redox balance in the serum of patients with systemic lupus erythematosus (SLE) and systemic vasculitis (SV) was investigated. Excess in oxidative processes has been measured through concentration of lipid peroxides which was found to increase by 26% in SLE and 32% in SV. Antioxidant protection capacity against this oxidative aggression has been assessed both by determining the level of activity of the enzymes participating in this process (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase GSH-Px) and by determining the total antioxidant serum activity. The results have shown that, within antioxidant protection of the body against oxidative stress, glutathione peroxidase plays the most important role and its activity is significantly affected by the great concentration of lipidic peroxides. We have also shown that there is positive correlation (r = 0.91) between the level of lipidic peroxides and the extent to which the tissue is affected. The latter is assessed by studying the serum activity of lactate dehydrogenase. Therefore, these two biologic parameters are shown to be very useful when the study of the development of the diseases is undertaken.

Lipoproteins, lipidic peroxidation and total antioxidant capacity in serum of aged subjects suffering from hyperglycemia.

Quantitative alterations of serum lipoproteins were studied as well as lipidic peroxidation level and total antioxidant capacity in the serum of 265 subjects ranging in age between 60-70 years, out of which 97 showed levels of glycemia higher than normal. Increase of LDL and VLDL was found in 74.6% respectively 67% of the old-aged subjects researched, without also finding significant differences between sexes. Frequent association between the two metabolic disorders is seen without there being a statistical correlation between degree of dyslipidemia and blood glucose level. The level of lipid peroxidation, determined by serum malondialdehyde (MDA) concentration, is higher in subjects with dyslipidemia where glycemia level exceeds 200 mg%. Total antioxidant defence in old aged hyperglycemic patients decreases by 18% as against the value seen in the controls. The normally glycemic patients show a decrease in this activity by only 12%. Significant frequency of dyslipidemia in the old aged studied is associated with hyperglycemia and can be accounted for beyond biologic mechanisms characteristic of aging, through a deficient diet. Association of dyslipidemia with hyperglycemia, the high level of lipidic peroxides and the diminution of body capacity of annihilating them, actually represents an increase in risk factors for onset of vascular attacks.

Investigation of immune reactivity in alcoholism with hepatic disease of various degrees.

The clinical and experimental investigations of alcoholic liver disease, have proved that hepatocytes injury is associated with immunologic abnormalities, which can be one of the sources of these injuries. The acetaldehyde, the main ethanol metabolite modify liver cytosolic proteins and form new antigens. Thus acetaldehyde induces the synthesis of auto-antibodies. Some hypotheses maintain the autoimmune pathogenesis of these diseases. Research was carried out on some patient groups admitted in the alcohol addiction department of the Neurology and Psychiatry hospital "Professor Gh. Marinescu". We have investigated the alcohol depending individuals with various degrees of hepatic injuries. Four groups have been studied: the control group, the alcohol depending patients without liver disease, the patients with alcoholic hepatitis, the group with alcoholic cirrhosis. In order to investigate the immunologic response the research has been carried on, along the following lines: serum immunoglobulins level, serum C3 level, serum protein C reactive level by using IDR, serum circulating immune complexes by Hakova method, auto-antibodies (antinuclear AAN, antimitochondria AM and antismoothmuscle ASM) by using indirect immunofluorescence, T lymphocytes by E rosetting and lymphocytes by direct immuno-fluorescence. Clinical and experimental study of the alcoholic liver has shown that destruction of hepatocytes is accompanied by several immunological events.

Survey on some aspects of immunologic reactivity in old age.

The raport focuses on investigation of a sample of old people, mainly in their eighties, as against a control group of healthy subjects, aged between 25 and 40. In order to investigate the immunologic response the research has been carried on along the following lines. to show self Ab antinuclear (AAN), antimitochondrial (AM) and antismoth muscle (ASM), by using indirect immunofluorescence; to study alteration of serum immunoglobulins by using IDR; to study alteration of serum concentration of C3 fraction in the complement by using IDR; to determine immune complexes by using Haskova method; to investigate IR through R rosetting method. Immunologic reactivity (IR) disturbance was found, with respect to alteration of immunoglobulin ratio IgA, IgG, IgM vere slightly diminished. Self antibodies were present to a percentage of 17% as predominant of ASM, AM and AAN in decreasing order. Increase in C3 associated with increase in immune complexes could account for high incidence of cardio-vascular complications. Decline in IR is shown through the decrease in T lymphocytes where Ts is more markedly decreased as against decreased Ts. The results imbalance between stimulating activated cells and suppressive controlling cells. IR alteration could account for degenerative pathology in the subjects, namely, ATS, cardiovascular diseases, senility, pseudobulb syndrome, schizoaffective psychosis.

Oxidative stress and antioxidant protection in degenerative psychoorganic syndrome in old agers.

Changes of the redox balance are reflected at the blood level in old agers--chronically intoxicated with alcohol--presenting degenerative psycho-organic syndromes (DPOS). The parameters investigated were lipid peroxidation reduced glutathione and the total SH groups. The changes of the antioxidant enzymatic system expressed by the activity of superoxide dysmutase, of glutathione peroxidase and of catalase were also followed up. It was observed that compared with the control group the lipid peroxides increased by 70.69% and the blood concentration of G-SH and of the total SH groups decreased by 46.7% and 24.76%, respectively. Likewise enzymes such as GPx and CAT presented increases of 70.4% and respectively 68.3% associated with a decrease of 23.9% of SOD activity.

Study on physiopathology of the chronic psychoorganic syndrome. Investigation on the reactivity of the adrenal glands in patients with psychoorganic chronic.

Out of a great number of cases with chronic psychoorganic syndrome studied by us, we have selected, for investigation, a number of 100 cases which presented common symptomatology: a psychosyndrome showing, by a large number of manifestations such as asthenia, fatigability, adynamia with various degrees of intensity building up to reaction latency, diminution or even absence of initiative, basic-negativism, tendency to depression with feeling of futility, anxiety, lowered affective tonus. The intellectual activity is largely diminished, the stream of ideas is poor, and there is a limited domain of preoccupations. All these symptoms alongside with somatic, muscular, renal, respiratory, digestive and cardiovascular disorders have led us to the hypothesis of chronic deficiency of the hormones in the adrenal glands. The adrenal glands have been studied by indirect exploration of the hydroelectrolytic metabolism of the peripheral blood, the Thorn test and the Robinson-Power-Kepler test. For the exploration of the glucocorticoids, a basal test has been used such as the 17-hydroxycorticoid test, which measures cortisol elimination, or as the 11-desoxycorticosteroids and metabolites, or the colorimetric Porter-Silber method. Among the dynamic tests, we have used stimulating tests, the ACTH test (synthetic Synachtene), which measures cortisolemia and the 17-urinary corticosteroids, faster and easier than the Thorn test. In order to assess androgens, we have used the ACTH deposit dynamic test (Synachtene retard), which in the case of normal function of the adrenal glands, in 24 hours, doubles the elimination of 17-hydrocorticosteroids, 17-Ketosteroids, D. H. E. A., pregnandiol, pregnantriol.(ABSTRACT TRUNCATED AT 250 WORDS)

Circulating immune complexes in collagen diseases.

In a group of 75 patients with collagen diseases a study was carried out for the structural characterization of the circulating immune complexes (CIC) and the eventual detection of a correlation between these complexes and various serum biologic parameters. The results obtained have demonstrated: (a) the great variability of the structure of immune complexes even in the same type of disease and (b) the lack of correlation between the concentration of components in the CIC structure and the level of the same components in the serum. The lack of correlation may be explained by the great variety of immune complexes formation and the increase of any of the serum immunoglobulins does not necessarily mean its total or partial aggregation in the CIC structure.

Study on some reactivity aspects in chronical psychic-organic syndrome.

In the present work, a number of patients with chronic psychic-organic syndromes, with confuse states, with the exaggeration of some personality features during the beginning period of brain atherosclerosis or senility was studied. The anamnestic and psycho-organic syndromes in different dysfunctions degrees, the evolution of dysfunctions with vascular determination, the deficiency of some intelligence compounds were also investigated. We tried to analyse the psychometric results and to distinguish the functional dysfunction from the organic one using Raven's test, Thurstone's scale, WAIS scale and test. We also tried to distinguish the intellectual decrease of medium and deep level. We studied the reactivity, the plasma level of ACTH, ACTH-stimulation test, integrity of the hypophyseo-hypothalamic test. The multitude of results of paraclinical analysis correspond to the multitude of clinical syndromes. These studies are preliminary for a more thorough research of the physiopathology of this kind of patients. The detailed investigation of these patients' specific nature reactivity offers a lot of possibilities used for therapy.

Metabolic investigations in persistent depressive states in the elderly.

In a group of 100 elderly patients with persistent depressive states, a series of investigations were carried out: hematologic, lipid, protein, energy metabolism hydroelectrolytic and acid-base balance, blood rheologic properties, immunologic, reactivity and certain humoral and regulation mechanisms. The results were compared with those obtained in two control groups, identical in number, the former in the third age without depressive states and the latter of healthy adults. The results were evaluated statistically. The results demonstrate that in depressive elderly subjects changes of the various parameters studied occur in the same direction as those in the group of elderly subjects without depression, but are far more accentuated.