The development of blood and lymph vessels of human parathyroid glands in embryonal, fetal and postnatal period.

The aim of the article is to investigate the development of blood and lymph systems in human parathyroid glands in prenatal and postnatal periods. The first capillaries are observed in these glands already in the lunar month 2. At the middle of pregnancy blood supply is increased, being extremely abundant in lunar months 9 and 10, as well as during the first year of life. As parts of the lymph system, intercellular lymph spaces are noticed in the parathyroid glands already in the lunar month 2, and also later, when lymph vessels are situated along the gland or in its connective capsule and within the gland parenchyma respectively. All these findings could be connected with the early function of these glands, as well as with the possibility that parathyroid hormone (PTH) is not transferred by blood only but by lymph as well.

Pantoprazole, amoxycillin and either azithromycin or clarithromycin for eradication of Helicobacter pylori in duodenal ulcer.

BACKGROUND: Studies have shown that 1-week triple therapy consisting of a proton pump inhibitor, amoxycillin and clarithromycin may cure Helicobacter pylori infection in the majority of patients. AIM: To establish whether pantoprazole plus amoxycillin in association with either azithromycin or clarithromycin is useful in curing H. pylori infection in patients with a duodenal ulcer. METHODS: One hundred and ten patients with active duodenal ulcers and H. pylori infection were treated with pantoprazole (days 1-7, 40 mg b.d.; days 8-28 40 mg o.d.) plus amoxycillin 1 g b.d. for the first 7 days. Patients were randomly assigned to receive either azithromycin 500 mg o.d. for the first 6 days (PAAz group; n=55) or clarithromycin 500 mg b.d. for the first 7 days of treatment (PAC group; n=55). H. pylori status was determined by urease test and histology before the treatment, and again 4 weeks after cessation of any medication. RESULTS: One hundred and three patients completed the study. H. pylori infection was eradicated in 78% (39/50) of patients in the PAAz group (ITT analysis: 71%, 95% CI: 61-83%) vs. 81% (43/53) of patients in the PAC group (ITT analysis: 78%, 95% CI: 69-90%) (N.S.). All ulcers had healed. CONCLUSION: Our study shows that 1-week triple therapy with pantoprazole, amoxycillin and either azithromycin or clarithromycin is not satisfactory (<80% ITT H. pylori eradication rate).

High dose omeprazole plus amoxicillin and azithromycin in eradication of Helicobacter pylori in duodenal ulcers.

BACKGROUND: The aim of our study was to establish whether one-week triple therapy regimen (omeprazole, amoxicillin, azithromycin) with low dose (2 x 20 mg/day) or high dose omeprazole (2 x 40 mg/day) is more effective in curing H. pylori infection in patients with active duodenal ulcer disease. METHODS: One hundred and twenty patients with duodenal ulcer and H. pylori infection were treated with amoxicillin 2 x 1000 mg/day for the first 7 days plus azithromycin 500 mg/day for the first 6 days. Patients were randomly assigned to receive either omeprazole 2 x 20 mg/day for the first 7 days (group A; n = 60) or omeprazole 2 x 40 mg/day for the first 7 days (group B; n = 60). After 7 days all patients in both groups continued treatment with omeprazole (40 mg/day (days 8-14) and 20 mg/day (days 15-28)). H. pylori status was determined by urease test and histology before the treatment and 4 weeks after cessation of any medication. RESULTS: One hundred and thirteen patients completed the study. H. pylori infection was eradicated in 73.2% [41/56] of patients in group A (intention-to-treat [ITT] analysis: 68.3%; 95% CI: 58.6-80.4%) vs. 82.5% [47/57] of patients in group B (ITT analysis: 78.3%; 95% CI: 67.8-87.9%; NS). All ulcers had healed after 4 weeks of omeprazole treatment. Side effects, usually minor, were recorded in 12.5% (group A) and in 14% (group B) of patients (NS), but therapy was discontinued for only one patient in group B (NS). CONCLUSION: There was no statistically significant difference between one-week triple therapy regimen (omeprazole, amoxicillin, azithromycin) with high dose omeprazole (2 x 40 mg/day) and regimen with low dose omeprazole (2 x 20 mg/day) in curing H. pylori infection in patients with active duodenal ulcer disease.

Anthropological measurements of the skeleton and parathyroid glands growth during fetal development.

The article presents the investigation of histomorphological differentiation and growth of parathyroid glands in human fetus from the second to the ninth lunar month. The longer and the shorter diameter of these glands were measured. The obtained values are compared with the development and the growth intensity of the skeleton (biparietal head diameter and femoral length of a fetus from lunar months 3 to 9) and with the role of the placenta in the mentioned processes. The results of our investigation show the concordance of the skeletal growth with the development and histomorphological differentiation of these glands. The factors involved in these processes point out the complex relationship between the mother and fetus during osteogenesis, expressed on the hormonal level, in mineral metabolism and placental activity.

Pantoprazole versus omeprazole in the treatment of reflux esophagitis.

Pantoprazole is a new proton pump inhibitor with a potent antisecretory activity, well defined pharmacokinetics and safety profile. The aim of this single blind, randomized clinical trial was to compare the efficacy of pantoprazole (PAN) 40 mg/day and omeprazole (OME) 20 mg/day in patients with grade I and II GERD (Savary-Miller classification). A total of 120 patients were included (PAN = 60 and OME = 60). In the per protocol/analysis, healing rates at 4 weeks were 76.3% PAN and 71.2% OME (ns), and at 8 weeks 94.7% PAN and 92.9% OME (ns). In the intention to treat analysis, healing rates at 4 weeks were 75% PAN and 70% OME (ns), and at 8 weeks 90% PAN and 86.6% OME (ns). Both pantoprazole and omeprazole were well tolerated with no serious drug related adverse events. Pantoprazole 40 mg/day was found to be safe and effective therapy comparable to omeprazole 20 mg/day in the short-term treatment for reflux esophagitis (grade I and II).

Hypothermia and acute renal failure in the elderly.

During 1993-1998, in winter time 14 elderly patients: 8 female and 6 male aged 65-88, were treated because of hypothermia. Rectal temperature on admission was 20-34.9 degrees C. Sopor was present in 2 and various grades of coma were present in 10 patients. Arterial hypotension was recorded in 5, and shock in 9 patients. Increased serum creatinine level was found in 8 patients. The mean rectal temperature in the whole group was 31.3 degrees C +/- 4.7, ranging from 20.0 to 34.9 degrees C, and the mean serum creatinine level was 172.2 +/- 93.5, in range of 66.0 to 360.0 mumol/L. Negative correlation between those two parameters was found: r = -0.572. In 2 of them parameters of renal failure were analyzed: urine sodium concentration, creatinine urine/plasma ratio, urine osmolality, urine/plasma osmolality ratio, renal failure index and fractional excretion of filtered sodium. In one of the patients all parameters were within the range of functional oliguria, in an other the urine sodium concentration serum showed acute renal failure, but all other findings showed borderline values between functional oliguria and acute renal failure. Twelve out of 14 patients died within 1-216 hours from admission.

Omeprazole, azithromycin and amoxicillin or amoxicillin plus clavulanic acid in eradication of Helicobacter pylori in duodenal ulcer disease.

Treatment with omeprazole (OME), azithromycin (AZI) and amoxicillin (AMO) resulted in encouraging Helicobacter pylori cure rates in pilot and control studies. The aim of this study was to establish whether OME + AZI in combination with either AMO or ACA (amoxicillin plus clavulanic acid) are effective in curing H. pylori infection. A hundred patients with active duodenal ulcer and H. pylori infection were treated with OME (day 1-10: 2 x 40 mg/day, day 11-24: 40 mg/day, day 25-42: 20 mg/day) plus AZI 500 mg/day for the first 6 days. Patients were randomly assigned to either AMO 2 x 1000 mg/day (group A, n = 50) or ACA 2 x 1250 mg/day (group B, n = 50) during the first 10 days of treatment. H. pylori status was determined by urease test and histology before and 6 weeks after completion of therapy. Ninety-five patients completed the study. H. pylori infection was eradicated in 85.4% (41/48) patients from group A (intention-to-treat (ITT) analysis: 82%) versus 91.5% (43/47) patients from group B (ITT) analysis: 86%) (NS). All ulcer had healed after 42 days of omeprazole treatment. Side effects, usually minor, were recorded in 12.5% (group A) and 14.9% (group B) of patients (NS). Therapy had to be discontinued in two patients (one in group A and one group B) only. Ten-days treatment with OME and AZI (for the first 6 days) with AMO or ACA are simple and highly effective regimens to cure H. pylori infection in patients with duodenal ulcer disease.

[Hormonal therapy with aromatase inhibitor in advanced breast cancer]. / Hormonsko lijecenje uznapredovalog raka dojke blokatorom aromataze.

We investigated the aminogluthetimide therapy effect on 30 postmenopausal women with advanced breast cancer previously treated with tamoxifen as a first-line hormonal treatment. Aminogluthetimide exhibits anticancer effect by inhibition of aromatase enzyme which plays a key role in the conversion of androgen to estrogen in peripheral adipose tissue. This pathway presents the main source of estrogen in postmenopausal women. Mean duration of the treatment was 14.3 months. Complete remission has been achieved in 10% of all patients, and partial remission in 16.6%. Mean duration of free intervals was 16.1 months in the group with ER+/PgR+ hormonal status, which is significantly longer compared to the ER+/PgR- and ER-/PgR+ groups where it was 11.8 months (p < 0.01). Aminogluthetimide treatment led to significant decrease in estradiol (E2) and dehydroepiandrosterone-sulphate (DHAS) levels in plasma. Thus, the effect of aminogluthetimide therapy as a second-line hormonal therapy has a benefit in the treatment of metastatic hormon-dependent breast cancer patients.

Effects of mercury bichloride on mouse kidney polyribosome structure and function.

Polyribosome sedimentation pattern and their in vitro protein synthetic ability were investigated in kidneys of mice treated with a single injection of HgCl2. Mercury bichloride, after 1 h, evokes polyribosome disaggregation, the extent of which is logarithmically correlated with the dose in the range of 2.5-20 micromoles/kg. With the dose of 2.5 micromoles/kg the effect occurs in 1 h, it is maximal between 1 h and 3 h. After 6 h polyribosomes are reaggregated. Cycloheximide pretreatment does not prevent the HgCl2 induced disaggregation of kidney polyribosomes. The cell-free system derived from kidneys of HgCl2 treated mice (10 micromoles/kg, 1 h) has a decreased protein synthetic ability. Both, in livers of mice treated with 20 micromoles/kg HgCl2 and in isolated rat's reticulocytes incubated with 20 micro M HgCl2 during 1 h there were no apparent changes in the polyribosome sedimentation patterns.