[Significance of early echocardiography in acute myocardial infarct]. / A korai echocardiographia jelentósége acut myocardialis infarctusban.

The authors examined the role of echocardiography performed in the acute phase of the myocardial infarction, within 72 hours after hospitalization in order to reveal the diagnosis, to detect of the complications and mortality in hospital. 512 consecutive patients were examined by echocardiography. All of them were younger than 70, and they were treated at our department between 1st January, 1991 and 31st December, 1994 with acute myocardial infarction. In 34 cases the infarction was without Q wave. The most severe left ventricular wall motion abnormality was dyskinesis in 53, akinesis in 390, hypokinesis in 49 cases, normokinesis was detected in 20 patients. The detection of the wall motion abnormality helped to diagnose 27 right ventricular infarctions, 58 reinfarctions and 21 acute myocardial infarction with left bundle branch block. 43 patients (8.4%) died during the treatment. In all cases the pathological examination verified the diagnosis of the acute myocardial infarction, and at 4 patients free wall rupture had been revealed. Among the deceased left ventricular dilatation (16/43 versus 75/469, p < 0.001), ejection fraction lower than 40% (14/43 versus 52/469, p < 0.001), left ventricular wall motion abnormality index (16 segments; 1 = normokinesis, 2 = hypokinesis, 3 = akinesis, 4 = dyskinesis, 5 = aneurysm) higher than 2.0 (27/43 versus 93/469, p < 0.001), dyskinesis (12/43 versus 41/469, p < 0.001), pericardial effusion thicker than 5 mm (7/43 versus 31/469, p < 0.05), and right ventricular infarction (6/43 versus 21/469, p < 0.05) occurred significantly more often. Dyskinesis is a bad prognostic factor even in the case of good left ventricular function. According to the opinion of the authors, echocardiography performed at the early stage of acute myocardial infarction, increases the safety of the diagnosis and calls the attention to the patients with high risk.

[Peripartum cardiomyopathy with fatal outcome]. / Letális kimenetelü peripartum cardiomyopathia.

The authors reported the case of a 26 year-old primipara who had unexplained congestive cardiac failure on the 9th week after delivery. There was no previous disease in her history however her pregnancy endangered because of imminent abortion was preceded by 1 artificial and 2 spontaneous abortions. In the acute phase she had to be resuscitated because of ventricular fibrillation and then she had a pulmonary embolism followed by pneumonia and therefore she was in septic state for 4 weeks. After a 4 month clinical remission she died unexpectedly at home. At autopsy the histological appearance of myocarditis, thymic hyperplasia and hypoplastic vascular system were observed.

[Thoracic actinomycosis]. / Thoracalis actinomycosis.

The authors describe in their case study the history of a 51 year old man, at whom they verified without thoracotomy thoracal actinomycosis. They achieved recovery giving permanently high doses of Penicillin. In connection with this rare case the authors review pathogenesis, the symptomatology, the diagnosis and the therapy of actinomycosis. The authors have found only one case in the Hungarian literature, which was recognized without thoracotomy and was cured by antibiotic therapy within a short period of time.

Hepatic alterations in experimental paraquat intoxication.

Results obtained during experiments on rats intoxicated with Gramoxone herbicide containing 25 per cent paraquat are reported using light- and electron microscopic examinations. The development of the liver's lesion may be divided into three phases: in the first phase predominates the destruction of the cytoplasmic organella in the hepatocytes, in the second one the proliferation of the Kupffer cells and in the third one the lesion of the biliary region. The regeneration is slower than in case of a healthy liver: the hepatic parenchyma is recovering at first and only later the epithelium of the bile ducts. The mechanism of action of the paraquat intoxication is discussed.

[Pathomorphology of lung changes caused by gramoxone poisoning. Human pathologic and animal experimental studies]. / Pathomorphologie der durch Gramoxonvergiftung bedingten Lungenveränderungen. Humanpathologische und tierexperimentelle Untersuchungen.

An account is given in this paper of changes caused by Gramoxone, a week killer, to the human lung as well as to experimental material. The process of damage was found to depend on the amount of toxic substance involved and on the route of uptake. Fibrosis, eventually, is the greatest danger. Intraperitoneal application leads to squamous epithelium metaplasia in the lung.

[Importance of environmental factors for the development of liver cirrhosis]. / Uber die Bedeutung der Umweltfaktoren bei der Entwicklung der Leberzirrhose.

The frequency of cirrhoses drastically increased in the seventies. This increase was predominantly due to an augmentation of alcoholic cirrhosis in men. Cirrhosis is significantly more wide-spread in men than in women. Most of the cirrhoses in women are of unknown origin. Morphologically, the alcoholic cirrhoses are of the micronodular types in their great majority. Combined with HBsAg positivity, the macronodular type is most frequent. The classification in micro- and macronodular cirrhoses do not imply a different etiology but it may indicate different stages in cirrhosis of identic origin. Histologically, the signs of alcoholic hepatitis particularly help to trace back the alcoholic etiology. If HBsAg can be detected and the margins of the pseudolobules are moth- eatenlike , this speaks for a hepatitic origin. The lowest average age was observed in cases of alcoholic cirrhoses, the highest in HBsAg positive cirrhoses of women. Men suffering from cirrhosis die earlier than women. In the case of alcoholic origin, the bulk of the cirrhotic livers are eutrophic while, beside HBsAg positivity, the atrophic livers are prevailing. The two most frequent environmental causes of cirrhosis are alcoholic beverages and hepatitis. Better exploration of the environmental factors and clearing up the origin of cryptogenic cirrhoses are essential tasks of the future.