Anti-inflammatory treatment in dysfunction of pulmonary surfactant in meconium-induced acute lung injury.

Inflammation, oxidation, lung edema, and other factors participate in surfactant dysfunction in meconium aspiration syndrome (MAS). Therefore, we hypothesized that anti-inflammatory treatment may reverse surfactant dysfunction in the MAS model. Oxygen-ventilated rabbits were given meconium intratracheally (25 mg/ml, 4 ml/kg; Mec) or saline (Sal). Thirty minutes later, meconium-instilled animals were treated by glucocorticoids budesonide (0.25 mg/kg, i.t.) and dexamethasone (0.5 mg/kg, i.v.), or phosphodiesterase inhibitors aminophylline (2 mg/kg, i.v.) and olprinone (0.2 mg/kg, i.v.), or the antioxidant N-acetylcysteine (10 mg/kg, i.v.). Healthy, non-ventilated animals served as controls (Con). At the end of experiments, left lung was lavaged and a differential leukocyte count in sediment was estimated. The supernatant of lavage fluid was adjusted to a concentration of 0.5 mg phospholipids/ml. Surfactant quality was evaluated by capillary surfactometer and expressed by initial pressure and the time of capillary patency. The right lung was used to determine lung edema by wet/dry (W/D) weight ratio. Total antioxidant status (TAS) in blood plasma was evaluated. W/D ratio increased and capillary patency time shortened significantly, whereas the initial pressure increased and TAS decreased insignificantly in Sal vs. Con groups. Meconium instillation potentiated edema formation and neutrophil influx into the lungs, reduced capillary patency and TAS, and decreased the surfactant quality compared with both Sal and Con groups (p > 0.05). Each of the anti-inflammatory agents reduced lung edema and neutrophil influx into the lung and partly reversed surfactant dysfunction in the MAS model, with a superior effect observed after glucocorticoids and the antioxidant N-acetylcysteine.

[Indicators of inflammation in patients with coronary atherosclerosis - role of usCRP in diagnosis and disease progression prediction]. / Indikátory zápalu u pacientov s koronárnou aterosklerózou - úloha usCRP v diagnostike a predikcii prognózy ochorenia.

Atherosclerosis is being nowadays defined as chronic subclinical inflammatory disease. Recently published clinical and laboratory studies have shown that subclinical inflammation represents main role in initiation of creation, in progress and destabilization of atherosclerotic plaque. Screening including traditional cardiovascular risk factors fails in identification in more than 50% of individuals with later development of acute coronary syndrome. According to above mentioned reason indicators are being searched for, which would be usable to monitor the activity of atherosclerotic process. According to role of subclinical inflammatory process in pathogenesis of atherosclerosis, the determination of C-reactive protein using ultrasensitive method is being showed as perspective marker. Ultrasensitive C-reactive protein represents a strong, independent predictor of future cardiovascular events in apparently heal-thy individuals and has also prognostic utility in patients with acute coronary syndromes. Predictive capacity of C-reactive protein determination is independent of traditional risk factors and offers prognostic advantage as opposed to determination of lipids alone. The paper provides a review of currently available knowledge of possibilities for utilization of C-reactive protein laboratory assessment, as the main representative of acute phase proteins, in monitoring of creation and severity of coronary atherosclerosis, in possibilities of the disease prognosis determination and prediction of its acute complications, and also in prediction of prognosis in patient with already existing acute complication.

[Biophysical methods in diagnosis of intrapartal fetal hypoxia]. / Biofyzikálne metódy diagnostiky intrapartálnej fetálnej hypoxie.

OBJECTIVE: To evaluate validity of biophysical diagnostic methods of fetal hypoxia. DESIGN: A case-control study. SETTING: Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic. METHODS: We divided the patients according to pH in umbilical artery (UA) < 7.15 into two groups: controls (n = 36), and studied (n = 31), retrospectively. We performed continuous simultaneous fetal monitoring with cardiotocography (CTG), fetal pulse oxymetry (IFPO), and ST segment analysis of fetal electrocardiogram (STAN). STATISTICS: histograms, Kolmogorov-Smirnovov test, Mann-Whitney test, Spearman's rho; statistical significance: p < 0.05, Receiver Operating Characteristic curves, Area Under the Curve. RESULTS: The most frequent was intermediary CTG pattern (n = 32; 47.76%). Non-reassuring IFPO was in 22 cases (32.86%), and ST events were present in 4 cases (5.97%). CTG validity in prediction of pH in UA < 7.15: sensitivity 80.0%, specificity 50.0%, positive predictive value (PPV) 22.1%, and negative predictive value (NPV) 93.4%, respectively; IFPO sensitivity was 76.3%, specificity 71.4%, PPV 32.2%, and NPV was 94.4%. Validity of STAN was not significant, because of low frequency of ST events in our study. Satisfactory accuracy (AUC > 0.8) had combined continuous monitoring with CTG, IFPO and STAN. Good accuracy (AUC > 0.7) had CTG by itself, and combined monitoring with IFPO and STAN, respectively. IFPO by itself had only sufficient accuracy (AUC > 0.6). CONCLUSION: The most valid method of fetal wellbeing objectification is combined simultaneous monitoring with CTG, IFPO and STAN. Our results support the effort in the development of integrated sensor for CTG, IFPO, and STAN.

[Biochemical aspects of fetal hypoxia]. / Biochemické aspekty fetálnej hypoxie.

OBJECTIVE: To evaluate validity of biochemical diagnostic methods of fetal hypoxia. DESIGN: A case-control study. SETTING: Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic. METHODS: We included 67 patients, and they were retrospectively divided into group of controls (n=36), and studied group (n=31) according to pH in umbilical artery (UA) <7.15. Acid-base parameters were assessed with Rapidlab 248, Bayer Healthcare LLC, East Walpole, USA. We determined criterion for metabolic acidosis (MAC) as pH UA <7.15, resp. base deficit (BD) UA >12 mmol/l. Postpartal lactate concentration in umbilical vein (UV) and UA was determined with lactatemeter Accutrend Lactate, Roche Diagnostics, Switzerland. Quantitative assessment of fetal human protein S100B was provided with ELISA (Sangtec 100 ELISA, DiaSorin Inc., Stillwater, Minnesota, USA). Fetal erythropoietin concentration in UV was examined with immunoenzymatic assessment Access EPO (Beckman Coulter, Inc., Fullerton, CA, USA). STATISTICS: histograms, Kolmogorov-Smirnov test, Mann-Whitney test, Spearman's rho; statistical significance: p<0.05, Receiver Operating Characteristic curves, Area Under the Curve. RESULTS: The best correlation was between fetal acid-base parameters and lactate in UA (p<0.0005). Significant correlation was between EPO in UV, and protein S100B in UV (p<0.05). EPO in UV significantly correlated with lactate in UA (p<0.05). Correlation between EPO in UV and protein S100B was not significant. According to ROC curves in prediction of fetal hypoxia, we found an excellent accuracy (AUC>0.9) for lactate in UA, good accuracy (AUC>0.7) had EPO in UV. Results for protein S100B were not significant. The highest sensitivity had EPO in UV, while the highest specificity has had lactate in UA. CONCLUSION: An indisputable evidence of labor management quality is the fetal metabolic status. On the basis of our results, the suitable clinical markers are lactate and EPO, in addition to acid-base parameters.

The significance of clinical markers in the prediction of hemodynamic and cardiac complications of capnoperitoneum in patients at risk.

OBJECTIVES: The aim of this prospective study was to find out the predictive value of concomitant diseases of cardiovascular system (CVS), lungs and kidneys as well as metabolic diseases to be able to anticipate the potential origin of hemodynamic and cardiopulmonary complications as a result of insufflated CO2 peritoneum. METHODS: The study investigated eleven patients at the anaesthetic risk of ASA III-IV and cardiac risk of NYHA II-III in whom elective laparoscopic surgical intervention had been indicated. RESULTS: We have found out that the significance of the increase in biologic ANP markers, catecholamines and PRA was not sufficient to signal the deepening of cardiac dysfunction, latent cardiac failure or hemodynamic disorder (p > 0.01). The courses of regression lines have shown the dependence on the increased IAP (intra-abdominal pressure) of capnoperitoneum in PRA and adrenaline. The reactions of biologic markers correlated with reactions of clinical hemodynamic markers of BP and HR. We have proved that the increased level of IAP causes a significant increase in CVP (p < 0.01) being one of the factors determining the preload of right ventricle (RV) and in coincidence with intact transpulmonary circulation also the optimal function of left ventricle (LV). CONCLUSION: Our investigation of peroperative clinical and biologic markers of hemodynamics and neuroendocrine response to operative stress and development of CO2 peritoneum has proved that the course of laparoscopic operations in patients in the risk group of ASA III-IV and NYHA III does not necessarily have to be deteriorated by complications. It can be assumed that increased values of biologic markers regulate the neurohumoral response in the physiologic range and do not predict a severe CVS dysfunction within its course. (Tab. 2, Fig. 3, Ref. 22.)

Association between systemic lupus erythematosus and insertion/deletion polymorphism of the angiotensin converting enzyme (ACE) gene.

OBJECTIVE: ACE takes part in the renin-angiotensin and kallikrein-kininogen systems by creating angiotensin-II and inactivating bradykinin. ACE gene insertion/deletion polymorphism is associated with the level of circulating enzymes--subjects with the DD genotype have higher levels of circulating ACE than subjects with the II genotype and show an increased tendency towards impaired vascular function and structure. Patients with systemic lupus erythematosus (SLE) suffer from differentially expressed vascular pathology. We attempted to determine whether the type of ACE polymorphism could contribute to this pathology. METHODS: 101 SLE patients fulfilling the ACR criteria were investigated. The I/D polymorphism was ascertained by PCR, followed by electrophoresis of the amplified fragments and UV visualization. RESULTS: The frequency of the D allele was higher in the SLE group (0.623) than in the controls (0.520) (chi 2 test, p < 0.025). The distribution of the ACE genotype in SLE group was different from that in the control group (p < 0.05). An association between the DD genotype and visceral damage (p < 0.006) was observed. CONCLUSION: Our results suggest that in the multifactorially determined vascular pathology of SLE, changes associated with I/D polymorphism could influence vessel wall inflammation (monocyte adhesion and activation with cytokine release, T-lymphocyte metabolism), a tendency towards vascular impairment (neointimal proliferation, vasospasm, platelet activation, myocyte proliferation) and lead to the subsequent ischemia. The ACE gene could serve as the visceral damage indicator in SLE.

Cytotoxic T lymphocyte antigen 4 (CTLA-4) dimorphism in patients with systemic lupus erythematosus.

OBJECTIVE: Genetic susceptibility to systemic lupus erythematosus (SLE) is conferred not only by various genes within the major histocompatibility complex (MHC) region, but also by several other non-MHC linked genes. The negatively signalling molecule CTLA-4 is involved in establishing and maintaining of peripheral T cell tolerance, which controls T cell activation and reactivity. Its attenuating action helps to prevent an inappropriate initiation of T cell responses to self antigens and to terminate ongoing T cell responses. We tested if there was an association between CTLA-4 and SLE, a disease with B and T cell hyperreactivity and impaired peripheral T cell tolerance. METHODS: Using the polymerase chain reaction--restriction fragment length polymorphism method with Bbv I digestion, we assessed an exon 1 transition dimorphism (49 A/G) of the CTLA-4 gene in 102 SLE patients and in 76 healthy controls. RESULTS: The distribution of CTLA-4 exon 1 genotypes in the SLE group was significantly different from that in the controls (chi 2 = 6.178, p < 0.05). 17.6% of the SLE patients were G/G homozygotes compared to 5.3% of the controls; 36.3% were A/G heterozygotes vs 40.8% of controls; and 46.1% were A/A homozygotes vs 53.9% of the controls. The frequency of the G allele was significantly higher in SLE patients (35.8%) than in controls (25.7%; chi 2 = 4.142, p = 0.042). CONCLUSION: Our results indicate that the non-MHC linked CTLA-4 gene could confer susceptibility in SLE, as it does in various other autoimmune diseases (Hashimoto thyroiditis, Graves' disease, IDDM).

Salicylate intoxication after use of topical salicylic acid ointment by a patient with psoriasis.

The authors describe a therapeutically well managed case of severe salicylate intoxication in a patient with psoriasis who treated himself with 40 percent salicylic ointment applied to approximately 41 percent of his body surface. Nineteen hours after the application of salicylic acid, his blood level of the agent was 6.04 mmol/liter. The patient underwent hemodialysis and was discharged after fourteen days in good general health.

Financial equivalent, industry sponsored research and conflict of interest.

Conflicts of interest for the clinician(physician)-researcher are not limited only to direct and clear financial support by manufacturers of the pharmaceutical and medical device industry, but rather include delicate indirect monetary and research support. Today professionals face an inevitable choice between two opposing moral orders, one based in the primacy of ethical obligations to the sick, the other in the primacy of self-interest and the marketplace. Some medical ethicists urge, reshape ethical codes to conform to the ethos of the marketplace, which legitimates self-interest over beneficence and makes vices out of most of traditional virtues. Second opinion represents the ethicists who recommend a firm stand in belief that being a physician imposes certain specific obligations. Medicine is at heart a moral enterprise and those who practice it are de facto members of a moral community. The market introduces an alien-till this time unknown-set of economic values into an institution (medicine) whose inherent ends are altruistic, but in countries under health care reform it brings a complex of special ethical issues in connection with deficient legislation and not firm ethical rules adopted. (Ref. 17.)

[The effect of age and thyroxine on lipogenesis during ontogeny. Activity of malic enzyme]. / Vplyv veku a tyroxínu na lipogenézu pocas ontogenézy. Aktivita "malic" enzýmu.

In young rats of different ages of postnatal development the effect of short-term administration of thyroxine (T4) on the activity of malic enzyme (ME) was studied in brown adipose tissue (BAT), liver, heart and kidney. Thyroxine was injected in a dose sufficient to saturate all receptor sites, i.e. 1 microgram per 1 gram of B.W. during 3 consecutive days. The highest activities of ME were found in BAT. An increase in enzyme activities with age was observed in all tissues studied in control animals. Injections of T4 increased the activity od ME in the liver; in BAT a significant increase was found only the younger age group (6 days). In older animals (40 days) with high values in BAT of controls no further increase induced by T4 was observed. In the kidney as well as in the heart no significant changes were found after T4 administration. It is concluded that in developing animals BAT may play a more important role in lipid synthesis than considered so far. (Fig. 1, Ref. 7.)

The development of lipid metabolism. Changes in the level of fatty acids in serum during postnatal ontogenesis in the rat.

In young rats of 5 different age groups the spectrum (per cent) of 6 FFA was determined. The results show, that palmitic acid (C16:0) represents the main FFA in all age groups; at the end of the first week forms nearly 50 per cent. In adult animals (8-week-old) values decreased to 26 per cent. Similarly, the myristic acid (C14:0) was found highest in suckling animals (10 per cent) and decreased with age. The ratio of saturated to unsaturated FA (S/U) decreased with age. In other animals of 7 different age groups the concentration of total and of individual FFA was investigated. The results were expressed in nmol.l-1. Results showed, that the total concentration of FFA during the first postnatal month is nearly 2-times higher than in adults. The ratio of S/U FFA decreased from 1.81 to 0.85. The concentrations of individual FFA showed different age-dependent trend. Myristic and stearic acids (C14:0 and 18:0) increased with age till the 4th week. The concentrations of palmitic, oleic and linoleic acids were high during the first 3 weeks of age and decreased after weaning. The concentration of palmitate-oleic acid (C16:1) was lowest in all age groups as well as that of palmitic (C 16:0) was always the highest. These results show, that changes in concentration of individual FFA with age are not dependent only on the intake of the milk. (Tab. 3, Fig. 1, Ref. 8).

[Relation between levels of essential fatty acids in maternal milk, in maternal blood and in the blood of neonates 1 and 5 days after birth]. / Vztah medzi koncentráciou esenciálnych mastných kyselín v materskom mlieku a ich obsahom v krvi matiek a v krvi ich novorodencov 1. a 5. postnatálny den.

BACKGROUND: Linolenic, linoleic, and arachidonic acids as well as other polyunsaturated fatty acids are necessary for health as the precursors of eicosanoids and for the structure of developing membranes. OBJECTIVES: The aim of the present study was the determination of the level of 11 individual free fatty acids (FFA) in the milk and in the blood of mothers and newborns during the perinatal period. METHODS: In 21 women the FFA was determined in their colostrum as well as in the venous blood at the delivery in the hospital, and then again 5 days later at leaving the hospital. Simultaneously, the blood of newborns was collected as umbilical samples at birth and as venous blood on the 5th day. The study was performed on health term infants and mothers with normal gestational age. RESULTS: The results show a marked increase in total milk FFA as well as in most, but not all, individual FFAs during the followed period of the first 5 days. The values in the milk were always remarkably higher (the increase more than 2 orders) than in the blood. We have found no significant statistical correlation between values in the blood and those in the milk. The concentrations of all very important omega-3 FFAs (which are present in fish oil and in foods of marine fish origin) were always lower in all blood and milk samples in comparison with the levels of omega-6 FFAs (which are prevailing in lipids of our usual nutrition as are margarines and most of commercial oils). CONCLUSIONS: Our findings seem to be very important for preventive medicine and need to study further the relationship of low intake of O3FA to increased incidence of various allergies and other pathological syndromes in children. The very large range of a variance in the values of FFAs in the milk suggests the need of more profound study of the role of the food composition probably during the whole period of pregnancy, mainly as to the type of lipid composition. (Tab. 1, Fig. 6, Ref. 24.)

[Is PLA1/A2 gene polymorphism of platelet membrane glycoprotein IIIa a risk factor for myocardial infarct?]. / Je PLA1/A2 polymorfizmus génu pre trombocytárny membránový glykoproteín IIIa rizikovým faktorom infarktu myokardu?

BACKGROUND: The PlA1/A2 polymorphism of the human platelet membrane glycoprotein IIIa gene cause T-->C transition in the exon ii (position 1565) resulting in the leucine-->proline substitution in amino-acid sequence. This polymorphism was shown to be associated with increased risk of myocardial infarction (MI). AIM: To test genetic parameters of the PlA1/A2 polymorphism in our population and to assess the relation between mutant PlA2 allele and MI. METHODS: DNA was isolated from peripheral blood, collected from 40 patients with MI and with present risk factors (hypertension, hypercholesterolaemia, diabetes, obesity, smoking...), 33 patients with MI without risk factors, 34 controls with equivalent average age to both groups of the MI-patients, 58 control probands without MI in their family history and 33 healthy controls randomly recruited. After PCR amplification the resulting 267 bp fragment was digested with the restriction endonuclease NciI and subfragments were separated electrophoretically in 12% polyacrylamide gel. RESULTS: The frequency of the PlA2 allele was 0.121 in patients with MI without risk factors, 0.205 in patients with present risk factors, 0.162 in controls of the equivalent average age to the MI-patients, 0.172 in controls without MI in their family history and 0.20 in healthy controls randomly recruited. Genotype frequencies were in all groups in genetic equilibrium. Although the groups differed significantly (p < 0.01) in serum concentrations of total cholesterol, HDL-cholesterol, LDL-cholesterol, apolipoprotein A-1, apolipoprotein B and malondialdehyde, no significant differences in the serum concentrations of these metabolites between A1/A1, A1/A2 and A2/A2 genotypes were observed. CONCLUSIONS: PLA1/A2 polymorphism is associated with MI, however not as a dominant risk factor, but as a part of environmentally influencable multigene system. There is no relation between genotypes of the PLA1/A2 polymorphism and the lipoproteins plasma concentrations. (Tab. 4, Ref. 17.)

[Metaphylaxis and treatment of cystine lithiasis--personal experience]. / Metafylaxia a liecba cystínovej litiázy--vlastné skúsenosti.

The authors presented their own experience with treatment of cystine lithiasis in 7 patients, which has been performed during the course the past of ten years. Identification of cystine was performed by concrement submitted examination, using a polarizating microscope, and x-ray difractometric structural analysis. After stone extraction the patients were treated by a high fluid intake (diuresis over 2.5 l), alcalizating treatment involving citrates (Alkalit Spofa), and Penicilamin (Spofa), or Thiola (Santen) which are currently proved to be the most optimal approach. Recurrence of stones requiring percutaneous treatment, was observed in one of the patients during five years metaphylaxy. Another patient of the same group had three times stated cystine stone recurrence which passed spontaneously.

Development of brown adipose tissue in the rat and thyroxine administration influence.

The role of the thyroid hormone in the activity of brown adipose tissue (BAT) is in most papers underestimated and it is the noradrenaline which is considered as the main regulator. The aim of the presented experiments was the study of the effect of 2 or 3 administrations of thyroxine (T4) applied to young rats of different age on the weight of BAT. T4 was injected in relatively large doses, i.e. 1 microgram/gram BW/day dissolved in 0.005 mmol NaOH intraperitoneally. Changes in T4 injected animals were compared with their litter-mate control, which were injected with solvents. In control animals the relative weight in mg/100 g BW was significantly higher during the entire first postnatal month in comparison with adult animals. Three administrations of T4 caused significant increase in relative as well as in absolute weight in all age groups. The difference was significant in dry tissue also. When the change was expressed in percentage the greatest effect of T4 was found in 15- and 19-day-old animals. Another experiment followed the effect of only two injections of T4 on BAT to animals of 7 different litters but of the same age, i.e. on day 5 and 6 and euthanized as 7-day-old. In all litters the increase after T4 treatment was significant; the increase in % ranged from 20 to 40% and was influenced by the level in controls. The relative weight in control animals ranged from 620 to 920 mg/100 g BW. This between-litter variance is greater than the effect of T4.(ABSTRACT TRUNCATED AT 250 WORDS)

The development of lipid metabolism. Effect of short-term application of thyroxine on the level of fatty acids and albumin in serum during ontogenesis in rat.

In young rats of different age the effect of short-term administration of thyroxine (T4) on the level of 6 FFA was determined. The concentration of FFA was expressed in mmol/l as well as the molar ratio to serum albumin. The results show that the level of the total FFA and the ratio of saturated to unsaturated (S/U) FFA are high in control animals till the age of 21 days in comparison with adult animals. Administration of T4 caused marked increase in the total FFA in the youngest age group (8-day-old) and the effect increased with age. Differences in the trend of changes in individual FFA were found. In the concentration of myristic acid (C 14:0) a significant increase was found only till the age of 16 days; in the case of palmit-oleic acid the increase was significant in all age groups. T4 caused no significant changes in the values of stearic acid (18:0). When the data were expressed in terms of the molar ratio FFA/albumin, the changes were more pronounced. The peak values found in 16-day-old animals were 33.9 +/- 0.75; they represent a 2-times higher supply of FFA to tissues in comparison with control animals. In this study it was also found that the concentration of serum albumin in newborn animals is low and represents just 57% of adult values. The short-term application of T4 caused no changes in the concentration of serum albumin. The mechanism of T4 action on FFA during ontogenesis was not explained in this study.(ABSTRACT TRUNCATED AT 250 WORDS)

[Changes in cholesterol and triacylglycerol serum levels in rats during postnatal ontogenesis]. / Zmeny v koncentrácii cholesterolu a triacylglycerolov v sére potkanov pocas postnatálnej ontogenézy.

In the serum of young normal rats during the first two months of life the concentrations of triacylglycerols (TG) and of cholesterol (CH) were determined. Low values in both studied parameters found in newborn animals were followed by a marked increase during the first week of life. In comparison with adult animals high values remained during the first five weeks of life. The results are discussed with regard to the high intake of lipids by milk during the period of sucking, as well as from the point of possible mobilization of tissue lipid stores because of the similar trend in the ontogenetic expression of the gene coding the hormone-sensitive lipase (HSL). On the basis of evaluation of the analytical as well as biological variance it was found, that for the level of 50% of confidentiality the serum concentrations of cholesterol should be in the range X +/- 0.26 mmol/l. For the level of 95% the range of values is X +/- 0.67 mmol/l. It is suggested that these results could be used as reference values for serum lipids in the rat during ontogenesis. (Fig. 1, Ref. 21.)

[Short-term administration of increasing doses of thyroxine has a different effect on serum lipids in male rats and in female rats]. / Krátkodobá aplikácia stúpajúcich dávok tyroxínu má rozdielny úcinok na lipidy séra u samcov a samíc potkanov.

The effects of short-term administration of thyroxine (T4) on serum levels of cholesterol, HDL-cholesterol and triacylglycerols were studied on young adult rats. T4 was injected in three different doses, i.e. 125, 250 and 500 micrograms for four days. The results show significant sexual differences. T4 caused a significant decrease in HDL-cholesterol levels in both sexes. The concentration of cholesterol and triacylglycerol decreased only in males, namely after injections of the highest dose of T4. In females the T4 injections caused no effect in the investigated parameters. It is concluded, that also in short-term applications of hormones, the sex may significantly change the results. Presented results support the latest views on specific interrelationship between thyroid hormone and HDL in comparison with other types of LP. (Tab. 2, Ref. 16.).

[Endothelial dysfunction and lipid profiles: analysis of the EDO Study]. / Endotelová dysfunkcia a lipidový profil: analýzy stúdie EDO.

On the basis of experimental as well as clinical observations, endothelial dysfunction is (defined as impaired or absent endothelium-dependent relaxation) considered to be an important factor in the atherogenesis. Serum lipids abnormalities have been accepted as an epidemiological risk factor of atherosclerosis. In vitro, experimental as well as epidemiological studies revealed the fact, that lipoprotein oxidation plays an important role in atherogenesis. Recently invented non-invasive methods to test and measure the endothelial function in vivo opened the opportunity to study the influence of different serum lipids on the endothelial function directly. Therefore, we decided to employ this non-invasive method for studying the endothelial function and observe the influence of various levels of plasma lipids and lipoprotein oxidation on the endothelial function of arteries in middle-aged men, since they are the most endangered part of population. In our study we used a method of measuring the diameter of a. radialis by high-resolution ultrasound (Sonoline 450, Siemens, Japan) and further mathematical and statistical analysis of functional as well as relative vasodilation reserve followed these measurements. Blood samples were taken within 24 hours of ultrasonography to study serum lipids (total cholesterol, HDL, triglycerides) and parameters of oxidation/antioxidation (superoxid dismutase--SOD, malondialdehyde--MDA). Sixty men, 25-45 years old, from an area of basically the same level of pollution were examined. We found a negative correlation between FVDR and TCH (p = 0.01), FVDR and Tg (p = 0.002) and FVDR a TCH/HDL (p = 0.015). Positive correlation exists (p < 0.001) between TCH, Tg levels and TCH/HDL ratio and MDA level in all cases. Analysing further data from the EDO Study, we can conclude, that increased plasma lipids are more likely to be oxidized, which, in turn, is the probable reason of endothelium-dependent vasodilation impairment.

[Levels of alpha 1-antitrypsin in the blood of patients with chronic bronchitis]. / Hladiny alfa 1-antitrypsínu v sére chorých na chronickú bronchitídu.

Serum levels of alpha 1-antitrypsin were studied in 80 patients with chronic bronchitis. As a manifestation of the inflammatory response, nonsignificant increase was recorded compared to the group of healthy subjects. In discordance with literary data, no significant differences were found between bronchitics smokers and non-smokers. In 5 patients (6.2%), alpha 1-antitrypsin serum levels were below the lower limit of the reference range. The patients complained of cough, expectoration, and dyspnea. As a preventive measure, it is recommended to determine serum alpha 1-antitrypsin levels in smokers before they take up a job in a dusty environment and in bronchitics before inhalation treatment with proteolytic enzymes is administered. In alpha 1-antitrypsin deficit the value of substitution therapy in patients with emphysema is being emphasized.